Individual
DR. MYEASHA KHARIMA BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
949 BROADWAY DR, HATTIESBURG, MS 39401-7534
(601) 620-0075
(601) 620-0105
Mailing address
949 BROADWAY DR, HATTIESBURG, MS 39401-7534
(601) 620-0075
(601) 620-0105
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
14641
MD
122300000X
Dentist
DEN1000754
DC
1223P0221X
Pediatric Dentistry
30.023795
OH
1223P0221X
Pediatric Dentistry
Primary
3768-14
MS
Other
Enumeration date
09/03/2008
Last updated
09/06/2022
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