Provider Demographics
NPI:1679636237
Name:BURACK, SHARI LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHARI
Middle Name:LYNN
Last Name:BURACK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1788
Mailing Address - Country:US
Mailing Address - Phone:732-247-7878
Mailing Address - Fax:
Practice Address - Street 1:2 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1788
Practice Address - Country:US
Practice Address - Phone:732-247-7878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ152501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice