Provider Demographics
NPI:1750413167
Name:BURNS, DAVID ANDREW (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ANDREW
Last Name:BURNS
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 1:10380 MAGENTA DR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-8209
Mailing Address - Country:US
Mailing Address - Phone:317-773-9535
Mailing Address - Fax:317-773-4572
Practice Address - Street 1:110 LAKEVIEW DR
Practice Address - Street 2:SUITE 2
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1324
Practice Address - Country:US
Practice Address - Phone:317-773-4526
Practice Address - Fax:317-773-4572
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120106661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice