Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN24581 | FL |
NPI | 1609417815 |
---|---|
Provider Name | Dr. Arthur Farlow Burt |
First Address | Inglis, FL 34449-4012 |
Second Address | Crystal River, FL 34429-7910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2019 |
Last Update Date | 30/09/2019 |