Individual
BRITT D. BURCHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
205 TEACO RD, KENNETT, MO 63857-3236
(573) 888-3521
(573) 888-0973
Mailing address
205 TEACO RD, P.O. BOX 766, KENNETT, MO 63857-3236
(573) 888-3521
(573) 888-0973
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15011
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3031860
BC/BS OF TN
TN
01
—
856721
UNITED CONCORDIA
—
Enumeration date
12/06/2007
Last updated
05/09/2016
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