Alice M. Butterworth, D.D.S.

Organization Active NPI Pediatric Dentistry · Marion, IN

NPI 1669913182 · NPPES record last updated Mar 16, 2017

Key facts

NPI
1669913182
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Dentistry 1223P0221X
License
12007455 (IN)
Legal business name
ALICE M. BUTTERWORTH, D.D.S.
Practice address
803 W Gardner Dr
Marion, IN 46952-1819
Phone
(765) 664-0587
Fax
(765) 664-1407
NPI assigned
Mar 16, 2017
Organization subpart
No

Authorized official

Name
Wendy Marley
Title
Office Manager
Phone
(765) 664-0587

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223P0221X 12007455 IN Yes

Addresses

Primary practice location

803 W Gardner Dr
Marion, IN 46952-1819

Mailing address

803 W Gardner Dr
Marion, IN 46952-1819
Phone (765) 664-0587

Other identifiers

IdentifierTypeStateIssuer
100143680MedicaidIN

Other providers in Marion, IN

All providers in Marion, IN · Pediatric Dentistry in Indiana

Sources for this page

Verify at the official NPI Registry.