Organization
ARKANSAS ORTHODONTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN GRAY BURRIS DDS MDS PA (ORTHODONTIST)
(870) 972-8249
Entity
Organization
Contact information
Practice address
3409 GATEWAY COVE, JONESBORO, AR 72404
(870) 972-0460
Mailing address
3409 GATEWAY COVE, JONESBORO, AR 72404
(870) 972-0460
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3465
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167957631
—
AR
Enumeration date
06/09/2008
Last updated
08/19/2008
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