Individual
GORDON BERRY BURNETT SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1895 PHOENIX BLVD, SUITE 148, COLLEGE PARK, GA 30349-5533
(770) 997-4598
(770) 997-6944
Mailing address
1895 PHOENIX BLVD, SUITE 148, COLLEGE PARK, GA 30349-5533
(770) 997-4598
(770) 997-6944
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN007288
GA
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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