Provider Demographics
NPI:1184855439
Name:BUTLER FAMILY DENTAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:BUTLER FAMILY DENTAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-838-1477
Mailing Address - Street 1:9 CAREY AVE
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-1407
Mailing Address - Country:US
Mailing Address - Phone:973-838-1477
Mailing Address - Fax:973-838-4749
Practice Address - Street 1:9 CAREY AVE
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:NJ
Practice Address - Zip Code:07405-1407
Practice Address - Country:US
Practice Address - Phone:973-838-1477
Practice Address - Fax:973-838-4749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI024063001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty