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General NPI Number Information
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NPI Number | 1649286303
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Entity Type | Organization
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Legal Business Name | DR IRWIN L BURSTEIN DDS PC
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1060 COLVIN AVE
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City | BUFFALO
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State | NY
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Zip | 14223-1905
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Country | US
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Telephone | 716-873-7030
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Fax |
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Provider Business Mailing Address
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Address Line | 1060 COLVIN AVE
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City | BUFFALO
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State | NY
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Zip | 14223-1905
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Country | US
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Telephone | 716-873-7030
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IRWIN L BURSTEIN
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Credential | DDS
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Telephone | 716-873-7030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 22706
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License Number State | NY
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