Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN009712 | GA |
NPI | 1033193693 |
---|---|
Provider Name | Dr. David Michael Burnette |
First Address | Columbus, GA 31904-6091 |
Second Address | Columbus, GA 31904-6091 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 07/01/2019 |