Provider Demographics
NPI:1003902537
Name:BURDETTE, RODNEY EARL (DDS)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:EARL
Last Name:BURDETTE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 LOUDON RD.
Mailing Address - Street 2:STE. 202
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301
Mailing Address - Country:US
Mailing Address - Phone:603-228-1066
Mailing Address - Fax:603-228-5305
Practice Address - Street 1:739 LOUDON RIDGE RD.
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:NH
Practice Address - Zip Code:03307
Practice Address - Country:US
Practice Address - Phone:603-267-9434
Practice Address - Fax:603-267-1976
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1320122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist