Individual
DR. JONATHAN W BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2250 N REED STATION RD, SUITE 201, CARBONDALE, IL 62901-8101
(618) 519-9363
(618) 519-9364
Mailing address
2250 N REED STATION RD, SUITE 201, CARBONDALE, IL 62901-8101
(618) 519-9363
(618) 519-9364
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019-026124
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021-002074
IL
Other
Enumeration date
10/04/2005
Last updated
05/27/2009
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