Organization
ALICE M. BUTTERWORTH, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY MARLEY (OFFICE MANAGER)
(765) 664-0587
Entity
Organization
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
12007455
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100143680
—
IN
Enumeration date
03/16/2017
Last updated
03/16/2017
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