Individual
DR. BRANDY BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1276 MAIN ST, IMPERIAL, MO 63052-3861
(636) 223-7123
Mailing address
1276 MAIN ST, IMPERIAL, MO 63052-3861
(636) 223-7123
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2006016233
MO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
53055
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
9818
CO
Other
Enumeration date
08/25/2007
Last updated
01/08/2016
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