Organization
JOPLIN SURGICAL ARTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY R BURNETT DDS (VICE PRESIDENT)
(417) 621-0500
Entity
Organization
Contact information
Practice address
620 W 32ND ST STE B, JOPLIN, MO 64804-2526
(417) 781-4551
(417) 781-5809
Mailing address
620 W 32ND ST STE B, JOPLIN, MO 64804-2526
(417) 781-4551
(417) 781-5809
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
207-0
MO
Other
Enumeration date
09/20/2007
Last updated
12/07/2007
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