Organization
KRISTEN A BURRIS, D.D.S. L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTEN A BURRIS D.D.S. (OWNER)
(580) 938-2566
Entity
Organization
Contact information
Practice address
1515 SOUTH MAIN STREET, SHATTUCK, OK 73858
(580) 938-2566
(580) 938-2567
Mailing address
PO BOX 609, SHATTUCK, OK 73858-0609
(580) 938-2566
(580) 938-2567
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4628
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100090140A
—
OK
Enumeration date
05/08/2008
Last updated
05/08/2008
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