Provider Demographics
NPI:1912999194
Name:BURNARD, ROBERT D (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:BURNARD
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 1:4998 W BROAD ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-1647
Mailing Address - Country:US
Mailing Address - Phone:614-878-8249
Mailing Address - Fax:
Practice Address - Street 1:4998 W BROAD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1647
Practice Address - Country:US
Practice Address - Phone:614-878-8249
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH138521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice