Provider Demographics
NPI:1700998424
Name:DAVID K BURAN DMD PC
Entity Type:Organization
Organization Name:DAVID K BURAN DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:BURAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-943-0701
Mailing Address - Street 1:4485 NORTH TOWN SQUARE
Mailing Address - Street 2:STE 100
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-2242
Mailing Address - Country:US
Mailing Address - Phone:770-943-0701
Mailing Address - Fax:770-943-7666
Practice Address - Street 1:4485 NORTH TOWN SQUARE
Practice Address - Street 2:STE 100
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-2242
Practice Address - Country:US
Practice Address - Phone:770-943-0701
Practice Address - Fax:770-943-7666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10535122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty