J.dieter Burr, Dmd PA

NPI #1225309602 in Cocoa, Florida

Provider Information

NPI Number: 1225309602
Entity Type: Organization
Organization Name: J.dieter Burr, Dmd PA
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Jan 18, 2012
Last Updated: Jan 18, 2012

Practice Location

Address: 6825 N HIGHWAY 1
City: Cocoa
State: Florida
ZIP Code: 32927-5012
Phone: (321) 631-2111

Authorized Official

Name: DR. JUCKAPONG DIETER BURR, DMD
Title: MEMBER
Phone: (352) 223-5459

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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