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Individual

TODD C. BURRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
7070 RENNER RD, SUITE 202, SHAWNEE, KS 66217-3047
(913) 268-0888
(913) 268-3752
Mailing address
7070 RENNER RD, SUITE 202, SHAWNEE, KS 66217-3047
(913) 268-0888
(913) 268-3752

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60148
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200175
BCBS OF KS PROVIDER NUMBE
KS
01
32438028
BCBS OF KC PROVIDER #
KS
Enumeration date
01/05/2006
Last updated
03/04/2008
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