Healthcare Provider Details

I. General information

NPI: 1881671493
Provider Name (Legal Business Name): ALVIS DUANE BURRIS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 SOUTH STREET
CAMDEN DE
19934
US

IV. Provider business mailing address

1182 W BIRDIE LN
MAGNOLIA DE
19962-3103
US

V. Phone/Fax

Practice location:
  • Phone: 302-697-3125
  • Fax:
Mailing address:
  • Phone: 302-698-3402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberG10001179
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0001179
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: