Individual
KENNETH M. BURTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
105 BEN CASEY DR, SUITE 115, FORT MILL, SC 29708-8561
(803) 548-9910
(803) 548-9915
Mailing address
105 BEN CASEY DR, SUITE 115, FORT MILL, SC 29708-8561
(803) 548-9910
(803) 548-9915
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
3553/611
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903373
—
NC
05
—
ZA9491
—
SC
Enumeration date
10/17/2006
Last updated
09/06/2023
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