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Individual
DR. MIA BURNEY
Active
Individual
DR. MIA BURNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7040
LA
1223G0001X
General Practice Dentistry
G1-0001401
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7040
DENTAL LICENSE
LA
Enumeration date
04/20/2016
Last updated
01/05/2024
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