Individual
DR. BRIAN BURSETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
22 W CRYSTAL LAKE AVE, CRYSTAL LAKE, IL 60014-6104
(815) 459-9900
Mailing address
22 W CRYSTAL LAKE AVE, CRYSTAL LAKE, IL 60014-6104
(815) 459-9900
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019030241
IL
Other
Enumeration date
07/09/2015
Last updated
07/09/2015
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