Provider Demographics
NPI:1598310799
Name:BURGEE, SUZANNE KATHLEEN (RDH, BS, QDA)
Entity Type:Individual
Prefix:PROF
First Name:SUZANNE
Middle Name:KATHLEEN
Last Name:BURGEE
Suffix:
Gender:F
Credentials:RDH, BS, QDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 CENTRAL AVE E
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-3455
Mailing Address - Country:US
Mailing Address - Phone:410-693-5332
Mailing Address - Fax:
Practice Address - Street 1:1601 18TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2529
Practice Address - Country:US
Practice Address - Phone:202-462-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6738124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist