Provider Demographics
NPI:1427133859
Name:BURNS, JILL M (DDS)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:M
Last Name:BURNS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1836 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-3822
Mailing Address - Country:US
Mailing Address - Phone:765-966-6802
Mailing Address - Fax:765-966-6889
Practice Address - Street 1:1836 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-3822
Practice Address - Country:US
Practice Address - Phone:765-966-6802
Practice Address - Fax:765-966-6889
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN8597122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist