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General NPI Number Information
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NPI Number | 1336273929
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Entity Type | Individual
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Provider Name | MARINA ROSE BURDUSI DDS
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Gender | Female
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10 W BROADWAY
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City | BEL AIR
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State | MD
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Zip | 21014-3555
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Country | US
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Telephone | 410-385-9966
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Fax |
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Provider Business Mailing Address
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Address Line | 662 PORTLAND ST
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City | BALTIMORE
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State | MD
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Zip | 21230-2220
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Country | US
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Telephone | 410-625-9444
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13279
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License Number State | MD
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