Provider Demographics
NPI:1487927794
Name:BUTENSKY, DANIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:BUTENSKY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E 56TH ST
Mailing Address - Street 2:APT. 3J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3758
Mailing Address - Country:US
Mailing Address - Phone:201-709-5872
Mailing Address - Fax:
Practice Address - Street 1:154 W 14TH ST
Practice Address - Street 2:SUITE 4I
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7307
Practice Address - Country:US
Practice Address - Phone:212-777-0423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056829122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist