Provider Demographics
NPI:1265228373
Name:BUTERBAUGH, TYLER (DDS, MBS)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:BUTERBAUGH
Suffix:
Gender:M
Credentials:DDS, MBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 PERSIMMON DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-7135
Mailing Address - Country:US
Mailing Address - Phone:717-578-7699
Mailing Address - Fax:
Practice Address - Street 1:1122 PERSIMMON DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-7135
Practice Address - Country:US
Practice Address - Phone:717-578-7699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program