Provider Demographics
NPI:1063614576
Name:DR CATHIE H BUTTERWORTH
Entity type:Organization
Organization Name:DR CATHIE H BUTTERWORTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:GWYN
Authorized Official - Middle Name:T
Authorized Official - Last Name:MONROE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-899-7791
Mailing Address - Street 1:2330 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4902
Mailing Address - Country:US
Mailing Address - Phone:540-899-7791
Mailing Address - Fax:540-899-8859
Practice Address - Street 1:2330 PLANK RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4902
Practice Address - Country:US
Practice Address - Phone:540-899-7791
Practice Address - Fax:540-899-8859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010065751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty