NPI | 1265647598 |
---|---|
Doing Business As | CHARLES J BURLISS DMD MSCD PC |
Entity Type | Organization |
Authorized Contact | CHARLES J BURLISS President 603-898-1961 |
Organization Subpart ? | No |
Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: NH 2529) |
Enumeration Date | 2007-05-11 |
Last Update Date | 2008-01-29 |