Boutz, John William
Boutz, John William is an individual health care provider with primary practice located at 7111 Prospect Pl Ne Suite C, Albuquerque NM 87110-4309. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Boutz, John William can be contacted via phone (505) 883-5773.Contact Information
Primary practice address
7111 Prospect Pl Ne Suite C
Albuquerque NM 87110-4309
Phone: (505) 883-5773
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | DD964 | New Mexico |
Profile Details
| NPI number | 1740265255 |
|---|---|
| LBN Legal business name | Boutz, John William |
| Credentials | D.D.S., M.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 7th, 2005 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740265255 | NPPES |
| New Mexico | MEDICAID | 80838 |
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