Provider Demographics
NPI:1669544904
Name:PINA, BURT D JR (DDS)
Entity type:Individual
Prefix:DR
First Name:BURT
Middle Name:D
Last Name:PINA
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1120
Mailing Address - Country:US
Mailing Address - Phone:301-439-1030
Mailing Address - Fax:301-439-4253
Practice Address - Street 1:10401 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1120
Practice Address - Country:US
Practice Address - Phone:301-439-1030
Practice Address - Fax:301-439-4253
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD116961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice