MEDICARE: DR. BARBARA BUTLER 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	1223G0001X	General Practice Dentistry	32303	CA

General Provider Information

NPI Number	:	1710154455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA BUTLER DDS

Provider Business Mailing Address
First Line	:	28222 AGOURA RD STE 104
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-2484
Country	:	US
Telephone Number	:	818-991-6718
Fax Number	:

Provider Business Practice Location Address
First Line	:	28222 AGOURA RD STE 104
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-2484
Country	:	US
Telephone Number	:	818-991-6718
Fax Number	:

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

Provider Enumeration Date	:	05/12/2008
Last Update Date	:	02/04/2016

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