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1306917588
LARRY DAVID BURNSIDE
JACKSONVILLE, FL
NPI
1306917588
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: FL 7825)
Enumeration Date
2006-11-10
Last Update Date
2007-07-08
Business Address
Dr. LARRY DAVID BURNSIDE DDS
12708 SAN JOSE BLVD
JACKSONVILLE, FL 32223-2689
Phone number: 904-268-0904
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Mailing Address
Dr. LARRY DAVID BURNSIDE DDS
711 CREIGHTON RD
ORANGE PARK, FL 32003-7008
Phone number: 904-264-2759
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