Provider Demographics
NPI:1871770248
Name:BURCAL, ROBERT GEORGE (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GEORGE
Last Name:BURCAL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:653 ORCHARD CT
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-2526
Mailing Address - Country:US
Mailing Address - Phone:847-688-2100
Mailing Address - Fax:847-688-5995
Practice Address - Street 1:2730 SAMPSON ROAD
Practice Address - Street 2:RTC BLDG 1017
Practice Address - City:GREAT LAKES
Practice Address - State:IL
Practice Address - Zip Code:60088-5258
Practice Address - Country:US
Practice Address - Phone:847-688-2100
Practice Address - Fax:847-688-5995
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0174271223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery