Tara Burgess, DDS Valid NPI
Individual provider · Dentist · Lake Jackson, TX
- NPI
- 1104200138
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- 31201 (TX)
- Sex
- Female
- Sole proprietor
- No
- Enumerated
- 2015-07-20
- Last updated
- 2015-07-20
Practice location
205 Parking Way St
Lake Jackson, TX 77566-5226
(979) 297-1128