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General NPI Number Information
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NPI Number | 1407719859
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Entity Type | Organization
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Legal Business Name | BURKS & BRYANT, LLC
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1355 E BRADFORD PKWY STE D
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City | SPRINGFIELD
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State | MO
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Zip | 65804-4200
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Country | US
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Telephone | 417-882-4600
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Fax | 417-882-1677
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Provider Business Mailing Address
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Address Line | 1355 E BRADFORD PKWY STE D
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City | SPRINGFIELD
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State | MO
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Zip | 65804-4200
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Country | US
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Telephone | 417-882-4600
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Fax | 417-882-1677
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. GINA ANN BURKS
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Credential |
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Telephone | 417-882-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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