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Individual

DR. BENJAMIN GRAY BURRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS, MDS

Contact information

Practice address
837 GOOD HOMES ROAD, ORLANDO, FL 32818
(870) 926-5321
Mailing address
837 GOOD HOMES ROAD, ORLANDO, FL 32818
(870) 926-5321

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
101237
CA
122300000X
Dentist
10186273-9921
UT
122300000X
Dentist
109030995
IL
122300000X
Dentist
200
OK
122300000X
Dentist
2009033293
MO
122300000X
Dentist
25757
TX
122300000X
Dentist
3465
AR
122300000X
Dentist
58955
NY
122300000X
Dentist
6020
LA
122300000X
Dentist
9071
TN
122300000X
Dentist
9869
KY
122300000X
Dentist
S3-222C
NV
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
104
AR

Other

Enumeration date
09/05/2006
Last updated
01/25/2018
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