Provider Demographics
NPI:1861581340
Name:BURBA, PATRICIA ANN
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:BURBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 EAST ST
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-4500
Mailing Address - Country:US
Mailing Address - Phone:978-681-7740
Mailing Address - Fax:978-681-5018
Practice Address - Street 1:60 EAST ST
Practice Address - Street 2:SUITE 3000
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-4500
Practice Address - Country:US
Practice Address - Phone:978-681-7740
Practice Address - Fax:978-681-5018
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA187631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice