Organization
BURKE ORTHODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON GLEN BURKE D.D.S, M.S.D (OWNER/MANAGER)
(435) 632-9742
Entity
Organization
Contact information
Practice address
817 W WILTSHIRE ST, WASHINGTON, UT 84780-8552
(435) 632-9742
Mailing address
817 W WILTSHIRE ST, WASHINGTON, UT 84780-8552
(435) 632-9742
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7598338-9921
UT
Other
Enumeration date
07/31/2010
Last updated
07/31/2010
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