Provider Demographics
NPI:1427263136
Name:BUTLER, LYNDA (DDS)
Entity type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SEVERANCE CIR STE 712
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1590
Mailing Address - Country:US
Mailing Address - Phone:216-381-3955
Mailing Address - Fax:216-381-7955
Practice Address - Street 1:5 SEVERANCE CIR STE 712
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1590
Practice Address - Country:US
Practice Address - Phone:216-381-3009
Practice Address - Fax:216-381-7955
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH180681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice