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NPI 1104076041

NPI 1104076041 : JAMES R BUTLER DDS : HUNTINGTON, WV

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General NPI Number Information
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    NPI Number           |    1104076041
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    Entity Type          |    Organization 
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    Legal Business Name  |    JAMES R BUTLER DDS 
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Dates
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    Enumeration Date     |    09/29/2008
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    Last Update Date     |    09/29/2008
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Provider Practice Location Address
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    Address Line         |    324 29TH ST 
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    City                 |    HUNTINGTON
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    State                |    WV
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    Zip                  |    25702-1428
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    Country              |    US
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    Telephone            |    304-523-2790
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    Fax                  |    304-523-2780
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Provider Business Mailing Address
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    Address Line         |    324 29TH STREET 
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    City                 |    HUNTINGTON
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    State                |    WV
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    Zip                  |    25702-1428
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    Country              |    US
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    Telephone            |    304-523-2790
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    Fax                  |    304-523-2780
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Authorized Official
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    Title or Position    |    OFFICE MANAGER
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    Name                 |    MS. CONNIE FAYE FIZER 
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    Credential           |    
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    Telephone            |    304-523-2790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    
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    License Number State |    
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