Provider Demographics
NPI:1396894432
Name:BURK, DANIEL F (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:F
Last Name:BURK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3936 CINNABAR ST
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6245
Mailing Address - Country:US
Mailing Address - Phone:925-755-3239
Mailing Address - Fax:
Practice Address - Street 1:3107 LONE TREE WAY
Practice Address - Street 2:SUITE A
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4980
Practice Address - Country:US
Practice Address - Phone:925-757-5081
Practice Address - Fax:925-757-4979
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA290211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice