Charles James Buttram Jr., D.D.S.
Individual provider Active NPI General Practice Dentistry · Raton, NM
NPI 1629114384 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1629114384
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 1059 (NM)
- Practice address
- 162 Hospital Dr
Raton, NM 87740-2002 - Phone
- (505) 445-3596
- NPI assigned
- Jan 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1059 | NM | Yes |
Addresses
Primary practice location
162 Hospital Dr
Raton, NM 87740-2002
Mailing address
162 Hospital Dr
P.O. Box 1206
Raton, NM 87740-2002
Phone (505) 445-3596
Other providers in Raton, NM
- Paul R Blackburn
- Ruth Bohlander
- Sheila Brooks
- Michael Lynn Brown
- Kayce L Bustos
- Cardinal Path Wellness LLC
- Debra Anne Carlisle
- Tanaye Marie Carroll-Maez
- Anna Caruana
- Lee C Caruana
All providers in Raton, NM · General Practice Dentistry in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.