Provider Demographics
NPI:1255692612
Name:BUTT, SANA JAVED (DDS)
Entity Type:Individual
Prefix:
First Name:SANA
Middle Name:JAVED
Last Name:BUTT
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 1:2579 EAGLE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-4707
Mailing Address - Country:US
Mailing Address - Phone:518-339-9113
Mailing Address - Fax:
Practice Address - Street 1:2579 EAGLE VIEW DR
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-4707
Practice Address - Country:US
Practice Address - Phone:518-339-9113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHWAITING FOR IT122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist