John S Burby, D.M.D.

Individual provider Active NPI General Practice Dentistry · Dade City, FL

NPI 1801026299 · NPPES record last updated Jul 20, 2009

Key facts

NPI
1801026299
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
7668 (FL)
Practice address
14018 5TH St
Dade City, FL 33525-4303
Phone
(352) 567-3573
Fax
(352) 567-6626
NPI assigned
Jul 20, 2009
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
7668FLMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7668 FL Yes

Addresses

Primary practice location

14018 5TH St
Dade City, FL 33525-4303

Mailing address

14018 5TH St
Dade City, FL 33525-4303
Phone (352) 567-3573

Other providers in Dade City, FL

All providers in Dade City, FL · General Practice Dentistry in Florida

Sources for this page

Verify at the official NPI Registry.