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General NPI Number Information
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NPI Number | 1184152415
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Entity Type | Individual
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Provider Name | MACKENZIE ANNE BUTCHER DMD
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Gender | Female
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Dates
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Enumeration Date | 05/31/2017
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 13053 W THUNDERBIRD RD
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City | EL MIRAGE
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State | AZ
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Zip | 85335-3261
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Country | US
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Telephone | 602-633-0444
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Fax |
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Provider Business Mailing Address
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Address Line | 13002 W LA TERRAZA DR
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-3250
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Country | US
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Telephone | 214-629-9536
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 34982
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D012337
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License Number State | AZ
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