Provider Demographics
NPI:1336400480
Name:BUTLER, JOKEIDRE (DDS)
Entity type:Individual
Prefix:DR
First Name:JOKEIDRE
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 FORTRESS BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-5568
Mailing Address - Country:US
Mailing Address - Phone:615-796-6362
Mailing Address - Fax:615-796-6394
Practice Address - Street 1:1141 FORTRESS BLVD
Practice Address - Street 2:STE D.
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128
Practice Address - Country:US
Practice Address - Phone:615-796-6362
Practice Address - Fax:615-796-6394
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN96031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice