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Individual

DR. CARROLL RAY BUTLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
321 W WATER ST, KERRVILLE, TX 78028-4297
(830) 257-4900
Mailing address
321 W WATER ST, KERRVILLE, TX 78028-4297
(830) 257-4900

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17648
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
74-28336328-89
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/07/2006
Last updated
07/09/2007
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