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Individual

DR. CHARLES J BURLISS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD,MSCD

Contact information

Practice address
12 STILES RD, SUITE 203, SALEM, NH 03079
(603) 898-1961
(603) 898-4508
Mailing address
12 STILES RD, SUITE 203, SALEM, NH 03079
(603) 898-1961
(603) 898-4508

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2529
NH

Other

Enumeration date
10/03/2006
Last updated
07/08/2007
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