Provider Demographics
NPI:1366475436
Name:BURSTEIN, WENDY C (DDS MS)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:C
Last Name:BURSTEIN
Suffix:
Gender:F
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EAST LEE STREET
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-6013
Mailing Address - Country:US
Mailing Address - Phone:410-727-6190
Mailing Address - Fax:410-659-0839
Practice Address - Street 1:2 EAST LEE STREET
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-6013
Practice Address - Country:US
Practice Address - Phone:410-727-6190
Practice Address - Fax:410-659-0839
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD127601223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics