Provider Demographics
NPI:1558578773
Name:BURNS, ANDREW W (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:W
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 1:290 EAST AGATE AVENUE
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:CO
Mailing Address - Zip Code:80446-1070
Mailing Address - Country:US
Mailing Address - Phone:970-887-3832
Mailing Address - Fax:
Practice Address - Street 1:1 W AGATE AVENUE
Practice Address - Street 2:
Practice Address - City:GRANBY
Practice Address - State:CO
Practice Address - Zip Code:80446-1070
Practice Address - Country:US
Practice Address - Phone:970-887-3832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9577122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist