Individual
DR. BRANT BURBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4255 N EAGLE RD STE 102, BOISE, ID 83713-0701
(208) 344-6300
Mailing address
1210 PINTAIL, SHERMAN, TX 75092-4244
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
35436
TX
1223G0001X
General Practice Dentistry
Primary
D-5145
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2019
Last updated
06/15/2020
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