Provider Demographics
NPI:1528064938
Name:BURNS, WILLIAM SAMUEL (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SAMUEL
Last Name:BURNS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 ROCKMONT DR
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-6477
Mailing Address - Country:US
Mailing Address - Phone:803-802-9030
Mailing Address - Fax:803-802-3152
Practice Address - Street 1:264 ROCKMONT DR
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6477
Practice Address - Country:US
Practice Address - Phone:803-802-9030
Practice Address - Fax:803-802-3152
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice