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Contact Information

BETHEL BURRIS OLIVER PLLC
203 S AVALON ST
WEST MEMPHIS, AR72301-4172
 Phone: 870-732-2275
 Fax: 870-732-1350
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
 

Orthodontics and Dentofacial Orthopedics

1223X0400X
 

Pediatric Dentistry

1223P0221X
Indicates primary specialty

NPI Profile & details for BETHEL BURRIS OLIVER PLLC

NPI # 1245644277
LBN Legal business name BETHEL BURRIS OLIVER PLLC
Authorized official BENJAMIN BURRIS - (D.D.S, M.D.S., P.A.)
Entity Organization
Organization subpart 1 No
Enumeration date 06/18/2014
Last updated 03/23/2015 - About 11 years ago
Identifiers
AR License # 3339
AR License # 3460
AR License # 3465
AR License # 4013
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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