Individual
DR. SHANE BLOOM BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3500 GASTON AVE, DALLAS, TX 75246-2017
(214) 820-2361
Mailing address
321 TALL TREES RD, WARREN, PA 16365-1459
(814) 779-9817
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
ETN844
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
TX
Other
Enumeration date
05/04/2021
Last updated
06/25/2021
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