Provider Demographics
NPI:1326464421
Name:SCOTT K. BUTTS, DDS, PA
Entity Type:Organization
Organization Name:SCOTT K. BUTTS, DDS, PA
Other - Org Name:AVENT FERRY FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:BUTTS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:919-452-6195
Mailing Address - Street 1:150 VILLAGE WALK DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-7679
Mailing Address - Country:US
Mailing Address - Phone:919-346-3656
Mailing Address - Fax:
Practice Address - Street 1:150 VILLAGE WALK DR
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7679
Practice Address - Country:US
Practice Address - Phone:919-346-3656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8630261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental