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General NPI Number Information
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NPI Number | 1700585189
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Entity Type | Organization
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Legal Business Name | PERRY J BURKE DMD PLLC
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 104 W WHEATON AVE
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City | CLARE
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State | MI
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Zip | 48617-1247
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Country | US
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Telephone | 989-404-0361
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Fax |
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Provider Business Mailing Address
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Address Line | 10275 E COLEMAN RD
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City | COLEMAN
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State | MI
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Zip | 48618-9612
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Country | US
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Telephone | 989-404-0361
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | PERRY J BURKE
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Credential | DMD
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Telephone | 989-404-0361
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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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