Provider Demographics
NPI:1356618433
Name:BURSTEIN, DANIEL ALLAN (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ALLAN
Last Name:BURSTEIN
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 1:1205 JOHNSON FERRY RD
Mailing Address - Street 2:STE 136, PMB 187
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-5418
Mailing Address - Country:US
Mailing Address - Phone:678-761-3284
Mailing Address - Fax:
Practice Address - Street 1:3300 OLD MILTON PKWY
Practice Address - Street 2:STE 380
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-2423
Practice Address - Country:US
Practice Address - Phone:678-761-3284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0111281223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics