Organization
BEECH LAKE PEDIATRIC DENTISTRY, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOMMY BURKE DDS (OWNER/DENTIST)
(731) 968-5437
Entity
Organization
Contact information
Practice address
10855 HIGHWAY 412 W, LEXINGTON, TN 38351-6283
(731) 968-5437
(731) 968-5439
Mailing address
10855 HIGHWAY 412 W, PO BOX 556, LEXINGTON, TN 38351-6283
(731) 968-5437
(731) 968-5439
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D8508
TN
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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