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General NPI Number Information
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NPI Number | 1124610126
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Entity Type | Organization
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Legal Business Name | BURKE CRAWFORD DDS PLLC
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Dates
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Enumeration Date | 02/10/2021
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 8996 BURKE LAKE RD STE 200
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City | BURKE
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State | VA
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Zip | 22015-1607
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Country | US
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Telephone | 703-798-9215
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Fax |
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Provider Business Mailing Address
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Address Line | 8996 BURKE LAKE RD STE 200
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City | BURKE
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State | VA
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Zip | 22015-1607
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | HUMAN RESOURCES
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Name | KYIAH D GILL
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Credential | MPH
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Telephone | 240-634-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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