Individual
DR. SHANNA BURRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1109 STATE ST, BOWLING GREEN, KY 42101-2648
(270) 781-8039
Mailing address
546 CERTAIN LN, GLASGOW, KY 42141-7742
(270) 646-8966
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8843
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100147050
—
KY
Enumeration date
09/26/2007
Last updated
03/07/2012
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