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General NPI Number Information
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NPI Number | 1003357351
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Entity Type | Individual
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Provider Name | LATOYA SHEMIA BUTLER DDS
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Gender | Female
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Dates
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Enumeration Date | 03/19/2017
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Last Update Date | 04/12/2018
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Provider Practice Location Address
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Address Line | 604 E 5TH AVE
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City | HAVANA
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State | FL
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Zip | 32333-1442
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Country | US
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Telephone | 850-539-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 MICCOSUKEE COMMONS DR APT 1105
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5439
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Country | US
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Telephone | 901-338-7381
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22475
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN22475
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License Number State | FL
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