Individual
DR. CLINTON BISSELL BUTLER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2410 SAMPSON ST, GREAT LAKES, IL 60088-2942
(847) 688-3331
Mailing address
322 68TH ST, KENOSHA, WI 53143-5132
(803) 767-0032
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9171
SC
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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