MEDICARE: COLTEN BUTLER DMD PLLC

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

General Provider Information

NPI Number	:	1730975095
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLTEN BUTLER DMD PLLC

Provider Business Mailing Address
First Line	:	4215 W WENDOVER AVE
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-1921
Country	:	US
Telephone Number	:	336-294-5020
Fax Number	:

Provider Business Practice Location Address
First Line	:	4215 W WENDOVER AVE
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-1921
Country	:	US
Telephone Number	:	336-294-5020
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. COLTEN LOUIS BUTLER
Credential	:	DMD
Telephone Number	:	435-668-0557

Provider Enumeration Date	:	04/15/2025
Last Update Date	:	04/15/2025

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