# BURNETT DDS ORAL & FACIAL SURGERY CENTER OF JOPLIN, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Oral & Facial Surgery Center of Joplin
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376592949
- **Authorized official:** BRADLEY R BURNETT DDS (PRESIDENT)
- **Authorized official phone:** (417) 621-0500

## Contact information

- **Practice address:** 620 W 32ND ST, JOPLIN, MO 64804
- **Practice address phone:** (417) 621-0500
- **Practice address fax:** (417) 781-5809
- **Mailing address:** 620 W 32ND ST, JOPLIN, MO 64804
- **Mailing address phone:** (417) 621-0500
- **Mailing address fax:** (417) 781-5809

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 010761 | MO | — |
| 1223E0200X | Endodontics | — | NULL | — |
| 1223E0200X | Endodontics | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2005005794 | MO | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | — |
| 2082S0099X | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | — | NULL | — |
| 2082S0099X | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | — | — | — |

## Other

- **Enumeration date:** 05/09/2006
- **Last updated:** 11/23/2009