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General NPI Number Information
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NPI Number | 1598560294
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Entity Type | Organization
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Legal Business Name | BURKHALTER DENTISTRY PLLC
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 2105 PINE ST
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City | HARLAN
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State | IA
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Zip | 51537-1898
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Country | US
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Telephone | 712-755-5342
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Fax | 712-755-5666
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Provider Business Mailing Address
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Address Line | 1708 CYCLONE AVE
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City | HARLAN
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State | IA
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Zip | 51537-1207
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Country | US
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Telephone | 402-617-7246
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Fax |
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | DR. ROY SIDNEY BURKHALTER III
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Credential | DDS
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Telephone | 402-617-7246
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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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