Kristen a Burris, D.D.S. L.L.C.

Organization Active NPI General Practice Dentistry · Shattuck, OK

NPI 1285801324 · NPPES record last updated May 8, 2008

Key facts

NPI
1285801324
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
4628 (OK)
Legal business name
KRISTEN A BURRIS, D.D.S. L.L.C.
Practice address
1515 South Main Street
Shattuck, OK 73858
Phone
(580) 938-2566
Fax
(580) 938-2567
NPI assigned
May 8, 2008
Organization subpart
No

Authorized official

Name
Dr. Kristen A Burris, D.D.S.
Title
Owner
Phone
(580) 938-2566

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 4628 OK Yes

Addresses

Primary practice location

1515 South Main Street
Shattuck, OK 73858

Mailing address

PO Box 609
Shattuck, OK 73858-0609
Phone (580) 938-2566

Other identifiers

IdentifierTypeStateIssuer
100090140AMedicaidOK

Other providers in Shattuck, OK

All providers in Shattuck, OK · General Practice Dentistry in Oklahoma

Sources for this page

Verify at the official NPI Registry.