IndividualActive
Mary Burke, DDS
NPI 1417166000 · Periodontics · Saint Louis, MO
Provider details
- NPI number
- 1417166000
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- Yes
- License
- 012706 (MO)
Specialties & taxonomies
Dental Providers
Practice location
5600 Oakland Ave
Dental Hygiene St Louis Community College-Forest Park
Saint Louis, MO 63110-1393
Phone: (314) 644-9630
Fax: (314) 951-9490
Approximate (ZIP-level) locationGet directions
Mailing address
918 Woodleigh Ct
Saint Louis, MO 63122-4805
Registry dates
- Enumerated
- 2007-05-21
- Last updated
- 2008-05-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.