Provider Demographics
NPI:1073643656
Name:BURNS, RICHARD HOWARD JR (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HOWARD
Last Name:BURNS
Suffix:JR
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 BLACKWOLF RUN RD
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33896-7952
Mailing Address - Country:US
Mailing Address - Phone:330-340-5259
Mailing Address - Fax:
Practice Address - Street 1:7975 OSCEOLA POLK LINE RD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33896-9104
Practice Address - Country:US
Practice Address - Phone:863-591-0402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0181661223X0400X
FLDN231321223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics