Provider Demographics
NPI:1124558291
Name:BURAU, ALEXANDER (DMD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:BURAU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6051 BROOKSTONE LN
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-9432
Mailing Address - Country:US
Mailing Address - Phone:810-516-4395
Mailing Address - Fax:
Practice Address - Street 1:530 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:DOWAGIAC
Practice Address - State:MI
Practice Address - Zip Code:49047-2101
Practice Address - Country:US
Practice Address - Phone:269-782-5161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29001022283122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist