Provider Demographics
NPI:1689710550
Name:BUTLER, DEBORAH ANNIE (DDS)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANNIE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6155 NEWGATE CIR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-5225
Mailing Address - Country:US
Mailing Address - Phone:760-845-4994
Mailing Address - Fax:
Practice Address - Street 1:6416 CARLISLE PIKE
Practice Address - Street 2:SUITE 500
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2393
Practice Address - Country:US
Practice Address - Phone:717-766-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS 0377281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice