Provider Demographics
NPI:1548425010
Name:KENNETH M. BURCH, DDS AND DIANA PALANDJIAN, DDS, LLC
Entity Type:Organization
Organization Name:KENNETH M. BURCH, DDS AND DIANA PALANDJIAN, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BURCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-767-6846
Mailing Address - Street 1:2387 CARLISLE RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-4007
Mailing Address - Country:US
Mailing Address - Phone:717-767-6846
Mailing Address - Fax:
Practice Address - Street 1:2387 CARLISLE RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-4007
Practice Address - Country:US
Practice Address - Phone:717-767-6846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KENNETH M. BURCH, DDS AND DIANA PALANDJIAN, DDS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030945L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty