Provider Demographics
NPI:1437299419
Name:DRS. BENNETT, BUTLER & ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:DRS. BENNETT, BUTLER & ASSOCIATES, LTD.
Other - Org Name:WILLIAMSBURG DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CORYDON
Authorized Official - Middle Name:B
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-229-7210
Mailing Address - Street 1:106 BACON AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-2908
Mailing Address - Country:US
Mailing Address - Phone:757-229-3099
Mailing Address - Fax:757-229-3243
Practice Address - Street 1:106 BACON AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2908
Practice Address - Country:US
Practice Address - Phone:757-229-3099
Practice Address - Fax:757-229-3243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty