Individual
JACOB SYDNEY BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
933 HARTFORD TPKE, VERNON, CT 06066-4407
(860) 870-4410
Mailing address
933 HARTFORD TPKE, VERNON, CT 06066-4407
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14037
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/15/2023
Last updated
07/24/2024
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