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General NPI Number Information
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NPI Number | 1417070459
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Entity Type | Organization
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Legal Business Name | BURK&FLINN ORTHODONTICS P.A.
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 656 QUINCE ORCHARD RD SUITE 110
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1409
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Country | US
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Telephone | 301-977-4200
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Fax | 301-869-5100
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Provider Business Mailing Address
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Address Line | 656 QUINCE ORCHARD RD SUITE 110
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1409
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Country | US
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Telephone | 301-977-4200
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Fax | 301-869-5100
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAUL MORTON BURK
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Credential | D.D.S,M.S.
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Telephone | 301-977-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 5312
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License Number State | MD
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