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General NPI Number Information
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NPI Number | 1710642012
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Entity Type | Organization
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Legal Business Name | HUGH D BURKE JR DDS INC.
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 8599 HAVEN AVE STE 105
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4849
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Country | US
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Telephone | 909-945-2342
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Fax | 909-948-5474
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Provider Business Mailing Address
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Address Line | 8599 HAVEN AVE STE 105
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4849
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Country | US
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Telephone | 909-945-2342
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Fax | 909-948-5474
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Authorized Official
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Title or Position | MANAGER
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Name | RITA BURKE
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Credential |
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Telephone | 909-945-2342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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