Provider Demographics
NPI:1306369921
Name:BUTLER, REBECCA LEIGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LEIGH
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 1:1379 BELLEVUE WAY NE APT A
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3694
Mailing Address - Country:US
Mailing Address - Phone:734-474-4869
Mailing Address - Fax:
Practice Address - Street 1:3943 116TH ST NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-8448
Practice Address - Country:US
Practice Address - Phone:360-651-9580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60776414122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist