Organization
J.DIETER BURR, DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUCKAPONG DIETER BURR DMD (MEMBER)
(352) 223-5459
Entity
Organization
Contact information
Practice address
6825 N HIGHWAY 1, COCOA, FL 32927-5012
(321) 631-2111
Mailing address
6825 N HIGHWAY 1, COCOA, FL 32927-5012
(321) 631-2111
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN19285
FL
Other
Enumeration date
01/18/2012
Last updated
01/18/2012
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