Provider Demographics
NPI:1093918500
Name:BURKE & BURKE
Entity Type:Organization
Organization Name:BURKE & BURKE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PTR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:BUKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-782-7746
Mailing Address - Street 1:503 5TH ST
Mailing Address - Street 2:
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-2628
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:503 5TH ST
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-2628
Practice Address - Country:US
Practice Address - Phone:419-782-7746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30. 013 4431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty