Mark Burgess, DMD

NPI 1154492593 · on the registry since 2006 · sole proprietor

Practice

Address: 2103 E Washington St Ste 4b
Bloomington, IL 61701
Phone: (309) 663-6564
Organisation at this address: Emil M. Verban
Tiffany Mcbride
Jsc Incorporated
Select Care Pllc
Keelan Dennis Mft
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 40

Registry record

Primary taxonomy: 1223G0001X
1223G0001X
Licence states on file: IL
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois