Provider Demographics
NPI:1093274763
Name:LEAH M. BUTLER, DDS, LLC
Entity Type:Organization
Organization Name:LEAH M. BUTLER, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-933-8705
Mailing Address - Street 1:15684 PINEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44149-5623
Mailing Address - Country:US
Mailing Address - Phone:330-933-8705
Mailing Address - Fax:
Practice Address - Street 1:16000 PEARL RD STE 10
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-6084
Practice Address - Country:US
Practice Address - Phone:440-238-4456
Practice Address - Fax:440-878-9127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental