Burnett, Bradley Robert
Burnett, Bradley Robert is an sole proprietor health care provider with primary practice located at 620 West 32Nd St Suite A, Joplin MO 64804-1623. He recently has 3 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Plastic Surgery Within the Head and Neck, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Burnett, Bradley Robert can be contacted via phone (417) 621-0500.Contact Information
Primary practice address
620 West 32Nd St Suite A
Joplin MO 64804-1623
Phone: (417) 621-0500
Fax: (417) 781-5809
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 2005005794 | Missouri |
Allopathic & Osteopathic Physicians / Plastic Surgery Within the Head and Neck | 2082S0099X | 2005005794 | Missouri |
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 2005005794 | Missouri |
Profile Details
NPI number | 1174683254 |
---|---|
LBN Legal business name | Burnett, Bradley Robert |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Dec 11th, 2006 |
Last updated | Jul 12th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1174683254 | NPPES |
Other | 1763846 | UNITED CONCORDIA NON-PAR | |
Other | 200505794 | UNITED CONCORDIA NON-PAR | |
Other | 1700470970 | UNITED CONCORDIA NON-PAR | |
Other | 005005794 | UNITED CONCORDIA NON-PAR |
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