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General NPI Number Information
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NPI Number | 1639138274
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Entity Type | Individual
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Provider Name | TOMMIE L. BURCHFIELD DMD
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Gender | Male
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 12/18/2014
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Provider Practice Location Address
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Address Line | 926 GREAT POND DR SUITE 1000
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-7244
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Country | US
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Telephone | 407-862-0444
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Fax | 407-862-2771
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Provider Business Mailing Address
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Address Line | 2216 E SEMORAN BLVD
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City | APOPKA
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State | FL
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Zip | 32703-5733
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Country | US
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Telephone | 407-889-4360
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Fax | 407-889-2035
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN9409
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License Number State | FL
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