Provider Demographics
NPI:1710062930
Name:BURKE, DARRYL DONALD (DDS)
Entity Type:Individual
Prefix:MR
First Name:DARRYL
Middle Name:DONALD
Last Name:BURKE
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 1:2975 TREAT BLVD STE A1
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-3690
Mailing Address - Country:US
Mailing Address - Phone:925-691-0238
Mailing Address - Fax:925-691-0213
Practice Address - Street 1:2975 TREAT BLVD STE A1
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-3690
Practice Address - Country:US
Practice Address - Phone:925-691-0238
Practice Address - Fax:925-691-0213
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41591122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist