Provider Demographics
NPI:1528418225
Name:BUTZ, DARLA CHRISTINE (EFDA)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:CHRISTINE
Last Name:BUTZ
Suffix:
Gender:F
Credentials:EFDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 NORTH PIEDRAS
Mailing Address - Street 2:US ARMY DENTAL ACTIVITY
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79920-5001
Mailing Address - Country:US
Mailing Address - Phone:915-742-6083
Mailing Address - Fax:
Practice Address - Street 1:5005 NORTH PIEDRAS
Practice Address - Street 2:US ARMY DENTAL ACTIVITY
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79920-5001
Practice Address - Country:US
Practice Address - Phone:915-742-6083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant