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Jason Boutwell, DMD
NPI 1144224478 · on the registry since 2005 · sole proprietor
Practice
- Address
- 3009 Chapel Hill Rd
Suite A
Douglasville, GA 30135 - Phone
- (770) 942-8288
- Fax
- (770) 942-9121
- Organisation at this address
- Amedisys Georgia, Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- General Practice Dentistry
1223G0001X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-09-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia