Provider Demographics
NPI:1679842512
Name:BUTLER, DAVID W (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:BUTLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9692 LEVIN RD NW STE 102
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-7801
Mailing Address - Country:US
Mailing Address - Phone:360-307-9797
Mailing Address - Fax:360-307-9494
Practice Address - Street 1:9692 LEVIN RD NW STE 102
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7801
Practice Address - Country:US
Practice Address - Phone:360-307-9797
Practice Address - Fax:360-307-9494
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA99281223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics