MEDICARE: DR. ROSHANJIT BUTTER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	061659	NY

General Provider Information

NPI Number	:	1528588183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSHANJIT BUTTER DDS

Provider Business Mailing Address
First Line	:	3117 68TH ST FL 1
Second Line	:
City	:	WOODSIDE
State	:	NY
Zip	:	11377-1224
Country	:	US
Telephone Number	:	347-536-7489
Fax Number	:

Provider Business Practice Location Address
First Line	:	183 N 6TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-3207
Country	:	US
Telephone Number	:	718-388-3737
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2017
Last Update Date	:	06/11/2021

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