Organization
BETHEL BURRIS OLIVER PLLC
Active
Organization
BETHEL BURRIS OLIVER PLLC
Active
Other names
Arkansas Dentistry and Braces
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN G BURRIS DDS, MDS, PA (OWNER)
(479) 445-6335
Entity
Organization
Contact information
Practice address
3500 WEST BLACK FOREST DRIVE, FAYETTEVILLE, AR 72704-5906
(479) 445-6335
Mailing address
3782 N FRONT ST STE 1, FAYETTEVILLE, AR 72703-5906
(479) 445-6335
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/24/2015
Last updated
07/17/2015
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