Provider Demographics
NPI:1063281293
Name:JOHN AND ALAN BURLEY DDS INC
Entity type:Organization
Organization Name:JOHN AND ALAN BURLEY DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-988-6272
Mailing Address - Street 1:604 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:OH
Mailing Address - Zip Code:45067-1432
Mailing Address - Country:US
Mailing Address - Phone:513-988-6272
Mailing Address - Fax:513-988-6267
Practice Address - Street 1:604 W STATE ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:OH
Practice Address - Zip Code:45067-1432
Practice Address - Country:US
Practice Address - Phone:513-988-6272
Practice Address - Fax:513-988-6267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty