Provider Demographics
NPI:1255627832
Name:ANDREW W BURNS DDS PC
Entity type:Organization
Organization Name:ANDREW W BURNS DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:W
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-887-3832
Mailing Address - Street 1:PO BOX 1070
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:CO
Mailing Address - Zip Code:80446-1070
Mailing Address - Country:US
Mailing Address - Phone:970-887-3832
Mailing Address - Fax:970-887-3925
Practice Address - Street 1:1 W AGATE AVENUE
Practice Address - Street 2:
Practice Address - City:GRANBY
Practice Address - State:CO
Practice Address - Zip Code:80446-1070
Practice Address - Country:US
Practice Address - Phone:970-887-3832
Practice Address - Fax:970-887-3925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO95771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty