MEDICARE: ROBERT R. BURKS, D.D.S., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN 8122	FL

General Provider Information

NPI Number	:	1346249901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT R. BURKS, D.D.S., P.A.

Provider Business Mailing Address
First Line	:	1142 E STATE ROAD 434
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-2715
Country	:	US
Telephone Number	:	407-327-2030
Fax Number	:	407-327-0044

Provider Business Practice Location Address
First Line	:	1142 E STATE ROAD 434
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-2715
Country	:	US
Telephone Number	:	407-327-2030
Fax Number	:	407-327-0044

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. ROBERT R. BURKS
Credential	:	D.D.S.
Telephone Number	:	407-327-2030

Provider Enumeration Date	:	07/17/2005
Last Update Date	:	05/18/2015

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