Provider Demographics
NPI:1619575339
Name:DANIEL BUTENSKY DMD, INC.
Entity Type:Organization
Organization Name:DANIEL BUTENSKY DMD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-273-1525
Mailing Address - Street 1:797 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-5109
Mailing Address - Country:US
Mailing Address - Phone:908-273-1525
Mailing Address - Fax:908-273-4858
Practice Address - Street 1:797 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-5109
Practice Address - Country:US
Practice Address - Phone:908-273-1525
Practice Address - Fax:908-273-4858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty