Provider Demographics
NPI:1780878264
Name:BURCHETT, JAMES ERIC (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ERIC
Last Name:BURCHETT
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Gender:M
Credentials:DDS
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Mailing Address - Street 1:1219 SILVER FERN DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-4775
Mailing Address - Country:US
Mailing Address - Phone:636-294-5437
Mailing Address - Fax:636-294-5438
Practice Address - Street 1:2958 HIGHWAY K
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-7861
Practice Address - Country:US
Practice Address - Phone:636-294-5437
Practice Address - Fax:636-294-5438
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2014-03-21
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Provider Licenses
StateLicense IDTaxonomies
MO20060323601223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry