Provider Demographics
NPI:1154445401
Name:BUREL, EDWARD C (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:C
Last Name:BUREL
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 1:34 BUCKMAN RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14615-1406
Mailing Address - Country:US
Mailing Address - Phone:585-254-1570
Mailing Address - Fax:585-458-2700
Practice Address - Street 1:34 BUCKMAN RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-1406
Practice Address - Country:US
Practice Address - Phone:585-254-1570
Practice Address - Fax:585-458-2700
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030811122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00466835Medicaid
NY7241OtherBLUE CROSS