MEDICARE: SCOTT K. BUTTS, DDS, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	8630	NC

General Provider Information

NPI Number	:	1326464421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT K. BUTTS, DDS, PA

Provider Business Mailing Address
First Line	:	150 VILLAGE WALK DR
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-7679
Country	:	US
Telephone Number	:	919-346-3656
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 VILLAGE WALK DR
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-7679
Country	:	US
Telephone Number	:	919-346-3656
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	MRS. MAUREEN CAROL BUTTS
Credential	:	FNP
Telephone Number	:	919-452-6195

Provider Enumeration Date	:	03/13/2014
Last Update Date	:	03/13/2014

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