Provider Demographics
NPI:1891819314
Name:BURT, DAVID ANDREW (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ANDREW
Last Name:BURT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 E HOMESTEAD LN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-7092
Mailing Address - Country:US
Mailing Address - Phone:484-926-1811
Mailing Address - Fax:
Practice Address - Street 1:2004 S 5TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6802
Practice Address - Country:US
Practice Address - Phone:610-791-2307
Practice Address - Fax:610-797-5858
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN020627A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice