Provider Demographics
NPI:1932220670
Name:BURGER, RICK J (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:J
Last Name:BURGER
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 1:1210 MEADOW BRIDGE DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-4300
Mailing Address - Country:US
Mailing Address - Phone:937-426-5303
Mailing Address - Fax:937-426-5566
Practice Address - Street 1:1210 MEADOW BRIDGE DR
Practice Address - Street 2:SUITE E
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434-4300
Practice Address - Country:US
Practice Address - Phone:937-426-5303
Practice Address - Fax:937-426-5566
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.017309122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist