Provider Demographics
NPI:1841324373
Name:BURLEY, DAVID CUTLER (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CUTLER
Last Name:BURLEY
Suffix:
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 1:251 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROMEO
Mailing Address - State:MI
Mailing Address - Zip Code:48065-5130
Mailing Address - Country:US
Mailing Address - Phone:586-752-9781
Mailing Address - Fax:
Practice Address - Street 1:251 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ROMEO
Practice Address - State:MI
Practice Address - Zip Code:48065-5130
Practice Address - Country:US
Practice Address - Phone:758-675-2978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI89761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice