Provider Demographics
NPI:1417420480
Name:BURKE D FREI DDS PLLC
Entity Type:Organization
Organization Name:BURKE D FREI DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BURKE
Authorized Official - Middle Name:
Authorized Official - Last Name:FREI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-661-7745
Mailing Address - Street 1:8438 E SHEA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6669
Mailing Address - Country:US
Mailing Address - Phone:480-661-7745
Mailing Address - Fax:480-661-5216
Practice Address - Street 1:8438 E SHEA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6669
Practice Address - Country:US
Practice Address - Phone:480-661-7745
Practice Address - Fax:480-661-5216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty