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Organization

BURRIS-DAKE LLC

Active
Other names
Poplar Bluff Orthodontics
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BENJAMIN G BURRIS DDS,MS (ORTHODONTIST)
15737761355
Entity
Organization

Contact information

Practice address
2951 KANELL BLVD, POPLAR BLUFF, MO 63901-4008
(573) 776-1355
(573) 776-1167
Mailing address
2951 KANELL BLVD, POPLAR BLUFF, MO 63901-4008
(573) 776-1355
(573) 776-1167

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary

Other

Enumeration date
11/09/2010
Last updated
11/09/2010
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