Provider Demographics
NPI:1083736920
Name:BURKE, TRUDY M (DDS)
Entity Type:Individual
Prefix:DR
First Name:TRUDY
Middle Name:M
Last Name:BURKE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1949 WESTFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1717
Mailing Address - Country:US
Mailing Address - Phone:908-322-1200
Mailing Address - Fax:908-322-2114
Practice Address - Street 1:1949 WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1717
Practice Address - Country:US
Practice Address - Phone:908-322-1200
Practice Address - Fax:908-322-2114
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ176641223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics