Individual
MICHAEL D BURLESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
113 W ARBOR LN, EDEN, NC 27288-5305
(336) 623-9143
(336) 627-0948
Mailing address
PO BOX 929, EDEN, NC 27289-0929
(336) 623-9143
(336) 627-0948
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4616
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8991182
—
NC
Enumeration date
11/01/2006
Last updated
07/08/2007
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