# BURRUS DENTISTRY PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pediatric Dental Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912304528
- **Authorized official:** DR. ELISE POREMSKI BURRUS DDS (PEDIATRIC DENTIST)
- **Authorized official phone:** (541) 923-8666

## Contact information

- **Practice address:** 413 NW LARCH AVE, SUITE 201, REDMOND, OR 97756-1361
- **Practice address phone:** (541) 923-8666
- **Mailing address:** 413 NW LARCH AVE, SUITE 201, REDMOND, OR 97756-1361
- **Mailing address phone:** (541) 923-8666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 11/25/2014
- **Last updated:** 11/25/2014