Organization
BURCH DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA KAY MILLER (VP OF OPERATIONS)
(815) 631-2389
Entity
Organization
Contact information
Practice address
9721 N ALPINE RD, MACHESNEY PARK, IL 61115-1664
(815) 633-9864
Mailing address
8100 FOREST HILLS RD, LOVES PARK, IL 61111-2709
(815) 633-9864
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19026526
IL
Other
Enumeration date
05/14/2013
Last updated
02/03/2025
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