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General NPI Number Information
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NPI Number | 1548322787
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Entity Type | Organization
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Legal Business Name | FAMILY DENTAL CENTER, P.C.
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 701 4TH AVE SUITE 3
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City | HOLDREGE
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State | NE
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Zip | 68949-2255
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Country | US
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Telephone | 308-995-6541
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Fax | 308-995-6542
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Provider Business Mailing Address
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Address Line | PO BOX 467
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City | HOLDREGE
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State | NE
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Zip | 68949-0467
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Country | US
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Telephone | 308-995-6541
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Fax | 308-995-6542
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ROBERT J. BUTZ
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Credential | D.D.S.
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Telephone | 308-995-6541
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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 | 4480
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License Number State | NE
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