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General NPI Number Information
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NPI Number | 1043420011
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Entity Type | Organization
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Legal Business Name | FRED BUETTNER DDS, INC.
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/28/2008
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Provider Practice Location Address
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Address Line | 709 SEQUOIA AVE
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City | LINDSAY
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State | CA
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Zip | 93247-1422
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Country | US
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Telephone | 559-562-5171
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Fax |
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Provider Business Mailing Address
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Address Line | 709 SEQUOIA AVE
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City | LINDSAY
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State | CA
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Zip | 93247-1422
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Country | US
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Telephone | 559-562-5171
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Fax |
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Authorized Official
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Title or Position | OFF. MGR
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Name | HAYLEY BUETTNER
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Credential |
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Telephone | 559-562-5171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 40059
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License Number State | CA
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