Individual
MR. CLYDE WALCEY BURRIS, III III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4950 GREENSBORO RD, RIDGEWAY, VA 24148-3390
(276) 956-9000
(276) 956-9002
Mailing address
PO BOX 483, RIDGEWAY, VA 24148-0483
(276) 956-9000
(276) 956-9002
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401008649
VA
Other
Enumeration date
03/06/2013
Last updated
03/06/2013
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