Provider Demographics
NPI:1578668042
Name:BUTURA, CAESAR C (DDS)
Entity type:Individual
Prefix:DR
First Name:CAESAR
Middle Name:C
Last Name:BUTURA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1277 E MISSOURI AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2915
Mailing Address - Country:US
Mailing Address - Phone:602-248-8745
Mailing Address - Fax:602-248-7939
Practice Address - Street 1:1277 E MISSOURI AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2915
Practice Address - Country:US
Practice Address - Phone:602-248-8745
Practice Address - Fax:602-248-7939
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ59501223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ823999OtherUNITED CONCORDIA
AZ0475500OtherBCBS
AZ804262OtherCMDP