Organization
CHILDRENS DENTAL SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE M. BUTTERWORTH D.D.S (OWNER)
(765) 664-0587
Entity
Organization
Contact information
Practice address
803 W GARDNER DR, MARION, IN 46952-1819
(765) 664-0587
Mailing address
803 W GARDNER DR, MARION, IN 46952-1819
(765) 664-0587
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12007455A
IN
Other
Enumeration date
01/15/2018
Last updated
01/15/2018
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