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Individual

DR. GREGORY BUTLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
919 FLORENCE AVE, FORT WAYNE, IN 46808-2354
(260) 632-8486
Mailing address
919 FLORENCE AVE, FORT WAYNE, IN 46808-2354
(260) 632-8486

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012219A
IN

Other

Enumeration date
10/27/2014
Last updated
10/27/2014
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