Provider Demographics
NPI:1972346799
Name:BURMA, SAMANTHA (DDS)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:BURMA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 INDUSTRIAL ROAD
Mailing Address - Street 2:
Mailing Address - City:FREEMAN
Mailing Address - State:SD
Mailing Address - Zip Code:57029
Mailing Address - Country:US
Mailing Address - Phone:605-925-4999
Mailing Address - Fax:
Practice Address - Street 1:1008 INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:FREEMAN
Practice Address - State:SD
Practice Address - Zip Code:57029
Practice Address - Country:US
Practice Address - Phone:605-925-4999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD14431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice