Provider Demographics
NPI:1790524627
Name:BUTTERMAN, KEVIN (DDS)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:BUTTERMAN
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 1:2343 S TROY CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3321
Mailing Address - Country:US
Mailing Address - Phone:303-588-2868
Mailing Address - Fax:
Practice Address - Street 1:3949 E ARAPAHOE RD STE 100
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2069
Practice Address - Country:US
Practice Address - Phone:303-221-3044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002059681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice