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Individual

DR. LEANN A BURCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
8100 FOREST HILLS RD, LOVES PARK, IL 61111-2709
(815) 633-9864
Mailing address
2202 CHURCHVIEW DR, UNIT N, ROCKFORD, IL 61107-2687
(815) 222-8662

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019026526
IL

Other

Enumeration date
02/27/2007
Last updated
08/11/2007
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