Provider Demographics
NPI:1437162971
Name:BUETTNER, FRED (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:
Last Name:BUETTNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 SEQUOIA AVE
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:CA
Mailing Address - Zip Code:93247-1422
Mailing Address - Country:US
Mailing Address - Phone:559-562-5171
Mailing Address - Fax:559-562-4891
Practice Address - Street 1:709 SEQUOIA AVE
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:CA
Practice Address - Zip Code:93247-1422
Practice Address - Country:US
Practice Address - Phone:559-562-5171
Practice Address - Fax:559-562-4891
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA400591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice