Provider Demographics
NPI:1740225861
Name:BURKE, JOHN P (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:BURKE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:1B COMMONS DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3442
Mailing Address - Country:US
Mailing Address - Phone:603-434-4914
Mailing Address - Fax:603-432-4509
Practice Address - Street 1:1B COMMONS DR
Practice Address - Street 2:SUITE 6
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3442
Practice Address - Country:US
Practice Address - Phone:603-434-4914
Practice Address - Fax:603-432-4509
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH12901223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHJOHN BURKEOtherORTHODONTIST