Individual
DONALD M BURKHOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
78 N CHESTNUT ST, JEFFERSON, OH 44047
(440) 576-7040
(440) 576-0022
Mailing address
128 MENTOR AVE, PAINESVILLE, OH 44077
(440) 354-2183
(440) 354-0811
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13444
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0176581
—
OH
Enumeration date
11/29/2006
Last updated
07/08/2007
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