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General NPI Number Information
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NPI Number | 1659426930
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Entity Type | Organization
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Legal Business Name | BURWINKEL FAMILY DENTRISTRY
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 323 N HIGH ST
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City | HILLSBORO
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State | OH
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Zip | 45133-1173
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Country | US
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Telephone | 937-393-1634
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Fax | 937-393-8509
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Provider Business Mailing Address
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Address Line | PO BOX 190
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City | HILLSBORO
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State | OH
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Zip | 45133-0190
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Country | US
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Telephone | 937-393-1634
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Fax | 937-393-8509
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Authorized Official
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Title or Position | OWNER
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Name | DR. PHILIP ANTHONY BURWINKEL
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Credential | D.D.S.
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Telephone | 937-393-1634
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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 | 30018490
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License Number State | OH
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