Butterworth, Alice Matilda
Butterworth, Alice Matilda is an sole proprietor health care provider with primary practice located at 803 W Gardner Dr , Marion IN 46952-1819. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Butterworth, Alice Matilda can be contacted via phone (765) 664-0587.Contact Information
Primary practice address
803 W Gardner Dr
Marion IN 46952-1819
Phone: (765) 664-0587
Fax: (765) 664-1407
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 12007455A | Indiana |
Profile Details
| NPI number | 1548202153 |
|---|---|
| LBN Legal business name | Butterworth, Alice Matilda |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 11th, 2006 |
| Last updated | Feb 27th, 2013 - about 12 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 | 1548202153 | NPPES |
| Indiana | MEDICAID | 100143680A |
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