Individual
BROOKS BURNSED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
255 NORTH WILSON AVE, SUITE D, NIPOMO, CA 93444
(805) 929-3219
(805) 929-4798
Mailing address
PO BOX 309, NIPOMO, CA 93444-0309
(805) 929-3219
(805) 929-4798
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
32522
CA
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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