Provider Demographics
NPI:1730975095
Name:COLTEN BUTLER DMD PLLC
Entity type:Organization
Organization Name:COLTEN BUTLER DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:COLTEN
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:435-668-0557
Mailing Address - Street 1:4215 W WENDOVER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1921
Mailing Address - Country:US
Mailing Address - Phone:336-294-5020
Mailing Address - Fax:
Practice Address - Street 1:4215 W WENDOVER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1921
Practice Address - Country:US
Practice Address - Phone:336-294-5020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental