Healthcare Provider Details

I. General information

NPI: 1235033135
Provider Name (Legal Business Name): FRANK D. BUTLER JR. DMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5520A OLD NATIONAL HWY STE 100
COLLEGE PARK GA
30349-3212
US

IV. Provider business mailing address

5520A OLD NATIONAL HWY STE 100
COLLEGE PARK GA
30349-3212
US

V. Phone/Fax

Practice location:
  • Phone: 404-767-8003
  • Fax: 404-393-0419
Mailing address:
  • Phone: 404-767-8003
  • Fax: 404-393-0419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. FRANK D BUTLER JR.
Title or Position: OFFICE MANAGER
Credential:
Phone: 404-767-8003