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General NPI Number Information
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NPI Number | 1528114600
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Entity Type | Individual
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Provider Name | PAUL J BUTLER DDS
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 2323 RACE STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19103
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Country | US
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Telephone | 215-460-6705
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Fax |
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Provider Business Mailing Address
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Address Line | 2323 RACE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19103-1072
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Country | US
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Telephone | 215-922-6516
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Fax | 215-922-3925
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DS021374L
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License Number State | PA
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