Organization Name: | JAMES K BURNHAM DDS, MS, PLLC |
NPI Number: | 1508142811 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES K BURNHAM (OWNER/PERIODONTIST) |
Mailing Address: | 101 11th St Ne East Wenatchee |
State: | WA US |
Postal Code: | 988024481 |
Phone Number: | 5098860664 |
Fax Number: | 5098869604 |
NPI Enumeration Date: | 11/01/2011 |
NPI Last Update Date: | 11/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | DE00009046 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |