Provider Demographics
NPI:1205960267
Name:BURTON, ROBERT BUCHANAN (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BUCHANAN
Last Name:BURTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 BISHOP LN
Mailing Address - Street 2:SUITE 506
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-1922
Mailing Address - Country:US
Mailing Address - Phone:502-451-6643
Mailing Address - Fax:502-451-2401
Practice Address - Street 1:1941 BISHOP LN
Practice Address - Street 2:SUITE 506
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-1922
Practice Address - Country:US
Practice Address - Phone:502-451-6643
Practice Address - Fax:502-451-2401
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY43751223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics