Provider Demographics
NPI:1427101872
Name:BURDUA, ANTHONY M (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:M
Last Name:BURDUA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 126
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:MI
Mailing Address - Zip Code:48471-0126
Mailing Address - Country:US
Mailing Address - Phone:810-648-3224
Mailing Address - Fax:
Practice Address - Street 1:749 N SANDUSKY RD
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:MI
Practice Address - Zip Code:48471-9143
Practice Address - Country:US
Practice Address - Phone:810-648-3224
Practice Address - Fax:810-370-0545
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI17882122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist