Individual
DR. JONATHAN S BURKE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D. D. S.
Contact information
Practice address
1410 E JOLIET ST, SUITE D, CROWN POINT, IN 46307-4724
(219) 662-9932
(219) 663-9688
Mailing address
1410 E JOLIET ST, SUITE D, CROWN POINT, IN 46307-4724
(219) 662-9932
(219) 663-9688
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009850
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12009850
LICENSE NUMBER
IN
Enumeration date
06/02/2006
Last updated
07/09/2007
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