Provider Demographics
NPI:1164523916
Name:BUTLER, HAROLD E (DDS MHA)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:E
Last Name:BUTLER
Suffix:
Gender:M
Credentials:DDS MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 508
Mailing Address - Street 2:10440 CHURCHILL ROAD
Mailing Address - City:MYERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21773
Mailing Address - Country:US
Mailing Address - Phone:301-293-3055
Mailing Address - Fax:
Practice Address - Street 1:11110 MEDICAL CAMPUS ROAD
Practice Address - Street 2:SUITE 148
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742
Practice Address - Country:US
Practice Address - Phone:240-313-9660
Practice Address - Fax:240-313-9661
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD71881223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery