Healthcare Provider Details

I. General information

NPI: 1568380095
Provider Name (Legal Business Name): BRYCE BUTLER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 N FEDERAL AVE
MASON CITY IA
50401-3250
US

IV. Provider business mailing address

1309 STENBERG DR
CLEAR LAKE IA
50428
US

V. Phone/Fax

Practice location:
  • Phone: 641-423-4225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10496
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: