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General NPI Number Information
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NPI Number | 1144568965
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Entity Type | Organization
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Legal Business Name | JEFFREY S. BUTTS DDS PC
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Dates
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Enumeration Date | 01/29/2013
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 3650 MARKETPLACE BLVD SUITE 920
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City | EAST POINT
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State | GA
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Zip | 30344-5741
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Country | US
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Telephone | 404-344-2323
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Fax | 404-344-8123
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Provider Business Mailing Address
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Address Line | 3650 MARKETPLACE BLVD SUITE 920
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City | EAST POINT
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State | GA
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Zip | 30344-5741
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Country | US
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Telephone | 404-344-2323
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Fax | 404-344-8123
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY STEPHEN BUTTS
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Credential | DDS
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Telephone | 404-344-2323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN014167
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License Number State | GA
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