Jonathan Marc Burrows, DDS

Individual provider Active NPI General Practice Dentistry · Mt Vernon, TX

NPI 1265958409 · NPPES record last updated Aug 18, 2017

Key facts

NPI
1265958409
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
33480 (TX)
Practice address
508 Texas Highway 37 S
Mt Vernon, TX 75457-6550
Phone
(801) 616-1135
NPI assigned
Aug 18, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
33480TXMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 33480 TX Yes

Addresses

Primary practice location

508 Texas Highway 37 S
Mt Vernon, TX 75457-6550

Mailing address

222 White St
Mt Pleasant, TX 75455-5451
Phone (801) 616-1135

Other providers in Mt Vernon, TX

All providers in Mt Vernon, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.