Provider Demographics
NPI:1245382837
Name:BURLEY, ERIKA V (DMD)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:V
Last Name:BURLEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 PROVIDENCE ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211
Mailing Address - Country:US
Mailing Address - Phone:704-364-7832
Mailing Address - Fax:704-364-7833
Practice Address - Street 1:2907 PROVIDENCE ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211
Practice Address - Country:US
Practice Address - Phone:704-364-7832
Practice Address - Fax:704-364-7833
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6804122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist