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General NPI Number Information
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NPI Number | 1528627130
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Entity Type | Organization
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Legal Business Name | BUTLER ENDODONTICS
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Dates
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Enumeration Date | 06/07/2019
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Last Update Date | 06/07/2019
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Provider Practice Location Address
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Address Line | 1140 N MAIN STREET EXT
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City | BUTLER
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State | PA
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Zip | 16001-1957
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Country | US
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Telephone | 412-780-1719
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 N MAIN STREET EXT
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City | BUTLER
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State | PA
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Zip | 16001-1957
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Country | US
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Telephone | 412-780-1719
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW WIRTZ
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Credential | DMD, MS
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Telephone | 412-780-1719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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