Provider Demographics
NPI:1538426960
Name:B. A. BURKHART, D. D. S., P.C.
Entity type:Organization
Organization Name:B. A. BURKHART, D. D. S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:B.
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURKHART
Authorized Official - Suffix:
Authorized Official - Credentials:D D S
Authorized Official - Phone:734-783-5255
Mailing Address - Street 1:25110 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48134-1072
Mailing Address - Country:US
Mailing Address - Phone:734-783-5255
Mailing Address - Fax:734-783-5228
Practice Address - Street 1:25110 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:MI
Practice Address - Zip Code:48134-1072
Practice Address - Country:US
Practice Address - Phone:734-783-5255
Practice Address - Fax:734-783-5228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty