Individual
DR. SPENCER DREW BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
PHOENIX INDIAN MEDICAL CENTER ATT: DENTAL, 4212 N. 16TH STREET, PHOENIX, AZ 85016
(602) 263-1200
(602) 263-1608
Mailing address
PHOENIX INDIAN MEDICAL CENTER ATT: DENTAL, 4212 N. 16TH STREET, PHOENIX, AZ 85016
(602) 263-1200
(602) 263-1608
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN12282
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
621393
—
AZ
01
—
AZ0419140
BLUE CROSS/BLUE SHIELD
AZ
Enumeration date
10/05/2006
Last updated
07/08/2007
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