Brandon Burleigh, DMD

Individual provider Active NPI General Practice Dentistry · Perry, GA

NPI 1831612787 · NPPES record last updated Jun 28, 2023

Key facts

NPI
1831612787
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN015470 (GA)
Practice address
1113 Morningside Dr
Perry, GA 31069-2905
Phone
(478) 224-5656
Fax
(478) 224-7676
NPI assigned
Jul 24, 2017
Sex
Male
Sole proprietor
No

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
DN015470GAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN015470 GA Yes

Addresses

Primary practice location

1113 Morningside Dr
Perry, GA 31069-2905

Mailing address

1113 Morningside Dr
Perry, GA 31069-2905
Phone (478) 224-5656

Other providers in Perry, GA

All providers in Perry, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.