Provider Demographics
NPI:1528178365
Name:BURKHARDT, DAVID RALPH (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RALPH
Last Name:BURKHARDT
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 1:2215 S LOOP 288
Mailing Address - Street 2:STE 406
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205
Mailing Address - Country:US
Mailing Address - Phone:940-891-0663
Mailing Address - Fax:940-484-4949
Practice Address - Street 1:2215 S LOOP 288
Practice Address - Street 2:STE 406
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205
Practice Address - Country:US
Practice Address - Phone:940-891-0663
Practice Address - Fax:940-484-4949
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13530122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist