Organization
BRYAN HALL BURDETTE
Active
Parent organization
BRYAN HALL BURDETTE
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRYAN HALL BURDETTE
Authorized official
MRS. WANDA JOAN HAYNES (OFFICE MANAGER)
(502) 245-1061
Entity
Organization
Contact information
Practice address
13050 MAGISTERIAL DR, SUITE 100, LOUISVILLE, KY 40223-5180
(502) 245-1061
(502) 245-1065
Mailing address
13050 MAGISTERIAL DR, SUITE 100, LOUISVILLE, KY 40223-5180
(502) 245-1061
(502) 245-1065
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
03223
KY
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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