Provider Demographics
NPI:1245205319
Name:DANCE AND BURSON, D.D.S., P.S.
Entity type:Organization
Organization Name:DANCE AND BURSON, D.D.S., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:ELDRED
Authorized Official - Last Name:DANCE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-698-5911
Mailing Address - Street 1:59 NE FAIRGROUNDS RD
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-8609
Mailing Address - Country:US
Mailing Address - Phone:360-698-5911
Mailing Address - Fax:360-698-4777
Practice Address - Street 1:59 NE FAIRGROUNDS RD
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-8609
Practice Address - Country:US
Practice Address - Phone:360-698-5911
Practice Address - Fax:360-698-4777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA45641223G0001X
WA45711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty