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Individual

DR. SPENCER JERALD BURTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4920 SOUTH 30TH STREET, SUITE 103, OMAHA, NE 68107-1656
(402) 932-7204
(402) 952-1020
Mailing address
4920 SOUTH 30TH STREET, SUITE 103, OMAHA, NE 68107-1656
(402) 932-7204
(402) 952-1020

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6935
NE
122300000X
Dentist
7429
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
483765
AZ
05
78732280
NM
Enumeration date
11/06/2007
Last updated
09/25/2012
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