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General NPI Number Information
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NPI Number | 1205893260
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Entity Type | Organization
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Legal Business Name | WILLIAM H BURKS DDS PA
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 06/27/2013
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Provider Practice Location Address
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Address Line | 1326 S MAIN ST
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City | OTTAWA
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State | KS
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Zip | 66067-3527
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Country | US
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Telephone | 785-242-4875
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Fax | 785-242-5325
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Provider Business Mailing Address
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Address Line | 1326 S MAIN ST
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City | OTTAWA
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State | KS
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Zip | 66067-3527
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Country | US
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Telephone | 785-242-4875
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Fax | 785-242-5325
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM H BURKS III
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Credential | DDS
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Telephone | 785-242-4875
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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 | 5996
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License Number State | KS
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