Provider Demographics
NPI:1104684695
Name:BUTTERNUT FAMILY DENTISTRY,PC
Entity type:Organization
Organization Name:BUTTERNUT FAMILY DENTISTRY,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:DARLING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:315-373-0187
Mailing Address - Street 1:4010 UNDERBRUSH TRL
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-1119
Mailing Address - Country:US
Mailing Address - Phone:315-415-9608
Mailing Address - Fax:
Practice Address - Street 1:7278 BUCKLEY RD
Practice Address - Street 2:
Practice Address - City:NORTH SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-2649
Practice Address - Country:US
Practice Address - Phone:315-399-5119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUTTERNUT FAMILY DENTISTRY ,PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental