Provider Demographics
NPI:1598232696
Name:BUTLER DENTAL PC
Entity Type:Organization
Organization Name:BUTLER DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:812-645-3769
Mailing Address - Street 1:502 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-3428
Mailing Address - Country:US
Mailing Address - Phone:812-645-3769
Mailing Address - Fax:877-504-0082
Practice Address - Street 1:502 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-3428
Practice Address - Country:US
Practice Address - Phone:812-645-3769
Practice Address - Fax:877-504-0082
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUTLER DENTAL PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty