Organization
BETHEL BURRIS OLIVER PLLC
Active
Other names
Arkansas Dentistry and Braces
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN BURRIS DDS,MDS, PA (OWNER)
(479) 782-7080
Entity
Organization
Contact information
Practice address
4605 S PHOENIX AVENUE, FORT SMITH, AR 72903-1713
(479) 782-7080
(479) 782-7072
Mailing address
4375 N VANTAGE DRIVE, SUITE 202, FAYETTEVILLE, AR 72703-5128
(479) 445-6335
(479) 301-2878
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3339
AR
1223P0221X
Pediatric Dentistry
3460
AR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
4013
AR
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3465
AR
Other
Enumeration date
03/29/2013
Last updated
12/29/2016
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