Individual
CLARISSA BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 FARMINGTON AVE, STE C, FARMINGTON, NM 87401-4559
(505) 325-9133
Mailing address
8450 HOOD MESA TRL, FARMINGTON, NM 87402-1175
(505) 486-0838
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD3324
NM
Other
Enumeration date
07/07/2010
Last updated
08/06/2013
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