Individual
DR. ANDRE BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
808 E MANCHESTER BLVD, INGLEWOOD, CA 90301-1914
(310) 671-1234
Mailing address
808 E MANCHESTER BLVD, INGLEWOOD, CA 90301-1914
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60360
CA
Other
Enumeration date
06/01/2011
Last updated
05/01/2012
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