Individual
DR. BLAKE COLLIER BURNSTAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7013 KENWELL ST, DALLAS, TX 75209-4840
(214) 868-4234
Mailing address
7013 KENWELL ST, DALLAS, TX 75209-4840
(214) 868-4234
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
35639
TX
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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