Provider Demographics
NPI:1063037273
Name:SATAVA, EMMA (DDS)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:SATAVA
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 1:7769 S PRECIOUS OPAL DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-5727
Mailing Address - Country:US
Mailing Address - Phone:440-708-8566
Mailing Address - Fax:
Practice Address - Street 1:8160 S HOUGHTON RD STE 130
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-9720
Practice Address - Country:US
Practice Address - Phone:520-663-4089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0106671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice