Organization
BETHEL BURRIS OLIVER PLLC
Active
Other names
Arkansas Dentistry and Braces
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN BURRIS D.D.S., M.D.S., P.A. (OWNER)
(479) 443-1705
Entity
Organization
Contact information
Practice address
3782 N FRONT ST, SUITE 1, FAYETTEVILLE, AR 72703-5128
(479) 445-6335
Mailing address
3782 N FRONT ST, SUITE 1, FAYETTEVILLE, AR 72703-5128
(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
09/22/2014
Last updated
03/05/2015
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