Provider Demographics
NPI:1477503191
Name:BUURMA, BRIAN J (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:J
Last Name:BUURMA
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:3290 N WELLNESS DR
Mailing Address - Street 2:SUITE 270
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-7259
Mailing Address - Country:US
Mailing Address - Phone:616-994-6050
Mailing Address - Fax:616-994-6051
Practice Address - Street 1:3290 NORTH WELLNESS DRIVE
Practice Address - Street 2:SUITE 270
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424
Practice Address - Country:US
Practice Address - Phone:616-994-9722
Practice Address - Fax:616-994-9733
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2013-02-21
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Provider Licenses
StateLicense IDTaxonomies
MI29010175741223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4307374Medicaid