MEDICARE: DR. DAVID EDWARD BURKHARDT D.D.S.

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	122300000X	Dentist	7726	NC
2	122300000X	Dentist	2618	WV

General Provider Information

NPI Number	:	1750339206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID EDWARD BURKHARDT D.D.S.

Provider Business Mailing Address
First Line	:	4400 EARLY ST
Second Line	:	#10078
City	:	COLUMBIA
State	:	SC
Zip	:	29207-7009
Country	:	US
Telephone Number	:	803-467-0246
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 ABBEY PLACE
Second Line	:	SUITE 130, BUILDING 1
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-3825
Country	:	US
Telephone Number	:	704-512-2510
Fax Number	:	704-512-2511

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	11/14/2012

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Directions to “ DR. DAVID EDWARD BURKHARDT D.D.S.” Practice Location

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