MEDICARE: MELANIE M BURKE DMD PA

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	11831	MD

General Provider Information

NPI Number	:	1962539239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MELANIE M BURKE DMD PA

Provider Business Mailing Address
First Line	:	6700 B PARK HEIGHTS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-2412
Country	:	US
Telephone Number	:	410-764-7764
Fax Number	:	410-764-6900

Provider Business Practice Location Address
First Line	:	6700 B PARK HEIGHTS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-2412
Country	:	US
Telephone Number	:	410-764-7764
Fax Number	:	410-764-6900

Authorized Official
Title or Position	:	DENTIST OWNER
Name	:	DR. MELANIE M BURKE
Credential	:	DMD
Telephone Number	:	410-764-7764

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	10/28/2013

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