Provider Demographics
NPI:1407972938
Name:BUTLER, RONALD CLAY DE LYRH (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:CLAY DE LYRH
Last Name:BUTLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:RONALD
Other - Middle Name:CLAY
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:7211 N MESA
Mailing Address - Street 2:SUITE 1 SOUTH
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912
Mailing Address - Country:US
Mailing Address - Phone:915-581-7800
Mailing Address - Fax:915-587-8995
Practice Address - Street 1:7211 N MESA
Practice Address - Street 2:SUITE 1 SOUTH
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912
Practice Address - Country:US
Practice Address - Phone:915-581-7800
Practice Address - Fax:915-587-8995
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12943204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery