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Organization

ROCKFORD PEDIATRIC DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY BURCH DMD (OWNER)
(815) 980-5010
Entity
Organization

Contact information

Practice address
1055 FEATHERSTONE RD STE A, ROCKFORD, IL 61107-5904
(815) 520-0239
Mailing address
1055 FEATHERSTONE RD STE A, ROCKFORD, IL 61107-5904

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
04/15/2022
Last updated
04/15/2022
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