Healthcare Provider Details

I. General information

NPI: 1245643527
Provider Name (Legal Business Name): BUR-DENT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 06/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 STATE ROUTE 33 SUITE 3
MILLSTONE TOWNSHIP NJ
08535-9427
US

IV. Provider business mailing address

377 MILLSTONE RD
CLARKSBURG NJ
08510-1520
US

V. Phone/Fax

Practice location:
  • Phone: 732-414-1888
  • Fax: 732-414-1889
Mailing address:
  • Phone: 732-414-1888
  • Fax: 732-414-1889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number22DI0288800
License Number StateNJ

VIII. Authorized Official

Name: DR. JAMES C BURDEN
Title or Position: OWNER
Credential: D.M.D.
Phone: 732-414-1888