Provider Demographics
NPI:1093733925
Name:SAVELLI, ILSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ILSE
Middle Name:
Last Name:SAVELLI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ILSE
Other - Middle Name:
Other - Last Name:SAVELLI-CASTILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:355 K ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-1209
Mailing Address - Country:US
Mailing Address - Phone:619-427-1315
Mailing Address - Fax:619-427-7962
Practice Address - Street 1:355 K ST
Practice Address - Street 2:SUITE A
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-1209
Practice Address - Country:US
Practice Address - Phone:619-427-1315
Practice Address - Fax:619-427-7962
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA544161223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry