Provider Demographics
NPI:1316173412
Name:BURNS, AUSTIN ARGYLL (DDS)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:ARGYLL
Last Name:BURNS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 S FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:BRAZIL
Mailing Address - State:IN
Mailing Address - Zip Code:47834-3102
Mailing Address - Country:US
Mailing Address - Phone:812-448-8490
Mailing Address - Fax:
Practice Address - Street 1:924 S FOREST AVE
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834-3102
Practice Address - Country:US
Practice Address - Phone:812-448-8490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011301A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist