Provider Demographics
NPI:1861474694
Name:DANIEL C. BURCHFIELD, DMD ET AL PTR.
Entity Type:Organization
Organization Name:DANIEL C. BURCHFIELD, DMD ET AL PTR.
Other - Org Name:BURCHFIELD,RICHARDSON,MCLEOD,SHEA,WEST,ORAL & MAXILLO SURGERY PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:BURCHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:615-822-8403
Mailing Address - Street 1:131 INDIAN LAKE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-6210
Mailing Address - Country:US
Mailing Address - Phone:615-822-8403
Mailing Address - Fax:615-822-0542
Practice Address - Street 1:131 INDIAN LAKE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-6210
Practice Address - Country:US
Practice Address - Phone:615-822-8403
Practice Address - Fax:615-822-0542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3714232Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER