Individual
DR. SAMUEL JACKSON BURROW IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS,DMD
Contact information
Practice address
2711 RANDOLPH RD, SUITE 600, CHARLOTTE, NC 28207-2034
(704) 334-7202
(704) 372-6974
Mailing address
2711 RANDOLPH RD, SUITE 600, CHARLOTTE, NC 28207-2034
(704) 334-7202
(704) 372-6974
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9425
NC
Other
Enumeration date
08/13/2013
Last updated
08/13/2013
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