MEDICARE: DAVID M BURKE A PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	48886	CA

General Provider Information

NPI Number	:	1518138056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID M BURKE A PC

Provider Business Mailing Address
First Line	:	7811 LAGUNA BLVD
Second Line	:	SUITE 190
City	:	ELK GROVE
State	:	CA
Zip	:	95758-7941
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7811 LAGUNA BLVD
Second Line	:	SUITE 190
City	:	ELK GROVE
State	:	CA
Zip	:	95758-7941
Country	:	US
Telephone Number	:	916-684-4780
Fax Number	:	916-684-4774

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID MICHAEL BURKE
Credential	:	DDS
Telephone Number	:	916-684-4780

Provider Enumeration Date	:	03/12/2008
Last Update Date	:	03/12/2008

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