Individual
LA TONYA BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MEMORIAL MEDICAL DR, GREENVILLE, SC 29605-4407
(864) 351-2400
(864) 751-0479
Mailing address
PO BOX 287, GREENVILLE, SC 29602-0287
(864) 729-8246
(864) 751-0479
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
11014
SC
Other
Enumeration date
07/26/2017
Last updated
07/26/2017
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