NPI 1629637764

Beau Devereux Butzirus, DMD

Practitioner Dentist Cottleville, MO

Practice location

Address: 475 Miralago Shore Dr, Cottleville, MO 63376-3189
Phone: (636) 928-4090
Fax: (636) 928-4555

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 2019020087 (MO)

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Registry record

NPI: 1629637764
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Jun 2019
Record last updated: 18 Mar 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.