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Individual

DR. ALICE MATILDA BUTTERWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
803 W GARDNER DR, MARION, IN 46952-1819
(765) 664-0587
(765) 664-1407
Mailing address
803 W GARDNER DR, MARION, IN 46952-1819
(765) 664-0587
(765) 664-1407

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12007455A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100143680A
IN
Enumeration date
06/11/2006
Last updated
02/27/2013
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