| Doctor Name: | DR. RYAN BURT |
| NPI Number: | 1215379540 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DDS |
| License Number: | 112 |
| Business Practice Address: | 3300 North Running Creek Way Bldg F, Suite #101 Lehi, UT - 84043 |
| Business Phone Number: | 8017662266 |
| Business Fax Number: | |
| Mailing Address: | 148 Arbor Ct, OMAHA |
| State: | NE |
| Postal Code: | 681081725 |
| Phone Number: | 8018426116 |
| Fax Number: | |
| NPI Enumeration Date: | 07/29/2013 |
| NPI Last Update Date: | 06/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | 112 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NE |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |