Provider Demographics
NPI:1750648192
Name:BUTLER, BRIANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIANNE
Middle Name:
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 1:4235 BROOKLYN AVE NE APT 405
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5920
Mailing Address - Country:US
Mailing Address - Phone:425-478-0013
Mailing Address - Fax:
Practice Address - Street 1:4235 BROOKLYN AVE NE APT 405
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5920
Practice Address - Country:US
Practice Address - Phone:206-478-0013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADR602833391223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry