# BURTON ADVANCE DENTAL, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386973931
- **Authorized official:** DR. THOMAS J. NIVISON D.D.S. (PRESIDENT)
- **Authorized official phone:** (810) 742-6600

## Contact information

- **Practice address:** 5492 LAPEER RD, BURTON, MI 48509-2235
- **Practice address phone:** (810) 742-6600
- **Practice address fax:** (810) 742-5075
- **Mailing address:** 5492 LAPEER RD, BURTON, MI 48509-2235
- **Mailing address phone:** (810) 742-6600
- **Mailing address fax:** (810) 742-5075

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 14588 | MI | Yes |

## Other

- **Enumeration date:** 12/10/2009
- **Last updated:** 12/10/2009