Organization Name: | JEFFREY S. BUTTS DDS PC |
NPI Number: | 1144568965 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEFFREY STEPHEN BUTTS (OWNER) |
Mailing Address: | 3650 Marketplace Blvd Suite 920 East Point |
State: | GA US |
Postal Code: | 303445741 |
Phone Number: | 4043442323 |
Fax Number: | 4043448123 |
NPI Enumeration Date: | 01/29/2013 |
NPI Last Update Date: | 01/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |