Provider Demographics
NPI:1336939586
Name:BURTON, JACOB MICHAEL (DMD, MMS)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:MICHAEL
Last Name:BURTON
Suffix:
Gender:
Credentials:DMD, MMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 EISENHOWER DR STE 400
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-1614
Mailing Address - Country:US
Mailing Address - Phone:912-352-1032
Mailing Address - Fax:
Practice Address - Street 1:340 EISENHOWER DR STE 400
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-1614
Practice Address - Country:US
Practice Address - Phone:912-352-1032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-10
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program