Provider Demographics
NPI:1487848818
Name:BURR, CHRISTINA R (DMD)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:R
Last Name:BURR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MISS
Other - First Name:CHRISTINA
Other - Middle Name:ELIZABETH
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:119 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651
Mailing Address - Country:US
Mailing Address - Phone:864-877-6477
Mailing Address - Fax:864-877-6420
Practice Address - Street 1:119 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651
Practice Address - Country:US
Practice Address - Phone:864-877-6477
Practice Address - Fax:864-877-6420
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC43461223G0001X
SCSC4346122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX4346Medicare UPIN