Provider Demographics
NPI:1043430499
Name:BURIAK, DAVID JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:BURIAK
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 1:2 SOUTH MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:MILLERSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17062-0129
Mailing Address - Country:US
Mailing Address - Phone:717-589-3361
Mailing Address - Fax:
Practice Address - Street 1:2 SOUTH MARKET STREET
Practice Address - Street 2:
Practice Address - City:MILLERSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17062-0129
Practice Address - Country:US
Practice Address - Phone:717-589-3361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017815L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice