J Mark Burnett DDS Ps
Dentist, General Practice in University Place, WA. Organization (NPI-2).
NPI number1679679674
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1679679674
- Entity type
- Organization (NPI-2)
- Legal business name
- J Mark Burnett DDS Ps
- Organization subpart
- No
- Enumeration date
- Sep 16, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 4322 | WA | Yes |
Practice location
2603 Bridgeport Way WSuite I
University Place, WA 98466-4724
Phone 253-565-1181
Mailing address
2603 Bridgeport Way WSuite I
University Place, WA 98466-4724
Phone 253-565-1181
Authorized official
J Mark Burnett
Dentist
2535651181
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