Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 1320 | NH |
NPI | 1003902537 |
---|---|
Provider Name | Rodney Earl Burdette |
First Address | Concord, NH 03301 |
Second Address | Loudon, NH 03307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |