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Organization

S.J.BURROW,III.D.D.S.,M.S.,P.L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SAMUEL JACKSON BURROW III DDS,MS (ORTHODONTIST)
(704) 547-0803
Entity
Organization

Contact information

Practice address
10320 MALLARD CREEK RD, SUITE 150, CHARLOTTE, NC 28262-9756
(704) 547-8438
(704) 372-2690
Mailing address
2711 RANDOLPH RD, SUITE 600, CHARLOTTE, NC 28207-2034
(704) 334-7202
(704) 372-2690

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4617
NC

Other

Enumeration date
01/25/2010
Last updated
01/26/2010
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