Provider Demographics
NPI:1700084621
Name:SURBECK, BURLEIGH TURNER (DDS MSD)
Entity type:Individual
Prefix:DR
First Name:BURLEIGH
Middle Name:TURNER
Last Name:SURBECK
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:375 118TH AVE SE STE 100
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3575
Mailing Address - Country:US
Mailing Address - Phone:425-455-1944
Mailing Address - Fax:425-452-8843
Practice Address - Street 1:121 112TH AVE NE
Practice Address - Street 2:SUITE C
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5807
Practice Address - Country:US
Practice Address - Phone:425-455-1944
Practice Address - Fax:425-452-8843
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00092251223X0400X
WADE000092251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics