| Kristen A Burris, D.d.s. L.l.c. | |
|
1515 South Main Street Shattuck OK 73858 | |
| (580) 938-2566 | |
| (580) 938-2567 |
| Full Name | Kristen A Burris, D.d.s. L.l.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1515 South Main Street, Shattuck, Oklahoma |
| Authorized Official Name and Position | Kristen A Burris (OWNER) |
| Authorized Official Contact | 5809382566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristen A Burris, D.d.s. L.l.c. Po Box 609 Shattuck OK 73858-0609 Ph: (580) 938-2566 | Kristen A Burris, D.d.s. L.l.c. 1515 South Main Street Shattuck OK 73858 Ph: (580) 938-2566 |
| NPI Number | 1285801324 |
|---|---|
| Provider Enumeration Date | 05/08/2008 |
| Last Update Date | 05/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285801324 | NPI | - | NPPES |
| 100090140A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4628 (Oklahoma) | Primary |
Shattuck Dentistry & Braces Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1523 S Main St, Shattuck, OK 73858 Phone: 580-938-2566 Fax: 580-938-2567 |