Provider Demographics
NPI:1407915994
Name:KURT A. BUTZIN, D.D.S, P.C.
Entity Type:Organization
Organization Name:KURT A. BUTZIN, D.D.S, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:A
Authorized Official - Last Name:BUTZIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDD
Authorized Official - Phone:989-792-9441
Mailing Address - Street 1:1936 BAY ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3924
Mailing Address - Country:US
Mailing Address - Phone:989-792-9441
Mailing Address - Fax:989-792-9158
Practice Address - Street 1:1936 BAY ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3924
Practice Address - Country:US
Practice Address - Phone:989-792-9441
Practice Address - Fax:989-792-9158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010128961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty