# BURKE CRAWFORD DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fenton Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124610126
- **Authorized official:** KYIAH D GILL MPH (HUMAN RESOURCES)
- **Authorized official phone:** (240) 634-9900

## Contact information

- **Practice address:** 8996 BURKE LAKE RD STE 200, BURKE, VA 22015-1607
- **Practice address phone:** (703) 798-9215
- **Mailing address:** 8996 BURKE LAKE RD STE 200, BURKE, VA 22015-1607

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/10/2021
- **Last updated:** 02/10/2021