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Individual

DR. TERRY ALLEN BURGESS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
810 PALMER RD STE 103, MADISON, AL 35758-3115
(256) 772-2626
(256) 772-2602
Mailing address
810 PALMER RD STE 103, MADISON, AL 35758-3115
(256) 772-2626
(256) 772-2602

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4219
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009913345
AL
Enumeration date
02/01/2007
Last updated
07/21/2022
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