Organization
GATEWAY VENTURES LLC
Active
Other names
Arkansas Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN BURRIS D.D.S., M.D.S. (OWNER)
(479) 443-1705
Entity
Organization
Contact information
Practice address
3782 N FRONT ST, SUITE 1, FAYETTEVILLE, AR 72703-5128
(479) 443-1705
(479) 443-1586
Mailing address
3782 N FRONT ST, SUITE 1, FAYETTEVILLE, AR 72703-5128
(479) 443-1705
(479) 443-1586
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
AR
Other
Enumeration date
04/04/2013
Last updated
04/04/2013
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