Individual
DR. BLAKE BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9200 113TH STREET, SAINT PETERSBURG, FL 33708
(727) 394-6064
Mailing address
4936 MIRAMAR DR, APT. 4207, MADEIRA BEACH, FL 33708-3396
(843) 318-9525
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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