Provider Demographics
NPI:1194033191
Name:BURGER, DONALD BRUCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:BRUCE
Last Name:BURGER
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 1:115 CENTRAL PARK WEST
Mailing Address - Street 2:SUITE 11
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-873-5400
Mailing Address - Fax:212-579-2372
Practice Address - Street 1:115 CENTRAL PARK WEST
Practice Address - Street 2:SUITE 11
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:212-873-5400
Practice Address - Fax:212-579-2372
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038770122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist