Healthcare Provider Details
I. General information
NPI: 1972159002
Provider Name (Legal Business Name): BUTTERFOSS BARTON & PAPPAS ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2019
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4310 GEORGE WASHINGTON MEM HWY
GRAFTON VA
23692-2880
US
IV. Provider business mailing address
4310 GEORGE WASHINGTON MEM HWY
GRAFTON VA
23692-2880
US
V. Phone/Fax
- Phone: 757-898-5448
- Fax: 757-898-4187
- Phone: 757-898-5448
- Fax: 757-898-4187
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
BARTON
Title or Position: DOCTOR/OWNER
Credential: DMD
Phone: 757-898-5448