| NPI | 1740449339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN GRAY BURRIS Orthodontist 870-972-8249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AR 3465) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-08-19 |