Individual
DR. MARY HAGAN BURKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5600 OAKLAND AVE, DENTAL HYGIENE ST LOUIS COMMUNITY COLLEGE-FOREST PARK, SAINT LOUIS, MO 63110-1393
(314) 644-9630
(314) 951-9490
Mailing address
918 WOODLEIGH CT, SAINT LOUIS, MO 63122-4805
(314) 821-2588
(314) 821-2903
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
012706
MO
Other
Enumeration date
05/21/2007
Last updated
05/13/2008
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