| J.dieter Burr, Dmd Pa | |
|
6825 N Highway 1 Cocoa FL 32927-5012 | |
| (321) 631-2111 | |
| Not Available |
| Full Name | J.dieter Burr, Dmd Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6825 N Highway 1, Cocoa, Florida |
| Authorized Official Name and Position | Juckapong Dieter Burr (MEMBER) |
| Authorized Official Contact | 3522235459 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J.dieter Burr, Dmd Pa 6825 N Highway 1 Cocoa FL 32927-5012 Ph: (321) 631-2111 | J.dieter Burr, Dmd Pa 6825 N Highway 1 Cocoa FL 32927-5012 Ph: (321) 631-2111 |
| NPI Number | 1225309602 |
|---|---|
| Provider Enumeration Date | 01/18/2012 |
| Last Update Date | 01/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225309602 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN19285 (Florida) | Primary |
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