Provider Demographics
NPI:1598560294
Name:BURKHALTER DENTISTRY PLLC
Entity type:Organization
Organization Name:BURKHALTER DENTISTRY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:SIDNEY
Authorized Official - Last Name:BURKHALTER
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-617-7246
Mailing Address - Street 1:1708 CYCLONE AVE
Mailing Address - Street 2:
Mailing Address - City:HARLAN
Mailing Address - State:IA
Mailing Address - Zip Code:51537-1207
Mailing Address - Country:US
Mailing Address - Phone:402-617-7246
Mailing Address - Fax:
Practice Address - Street 1:2105 PINE ST
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:IA
Practice Address - Zip Code:51537-1898
Practice Address - Country:US
Practice Address - Phone:712-755-5342
Practice Address - Fax:712-755-5666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-17
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice