Provider Demographics
NPI:1154479715
Name:SAVOY, MARY CONNOLLY (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CONNOLLY
Last Name:SAVOY
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 1:8377 BRAUN CT
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-5815
Mailing Address - Country:US
Mailing Address - Phone:720-260-3401
Mailing Address - Fax:
Practice Address - Street 1:8377 BRAUN CT
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-5815
Practice Address - Country:US
Practice Address - Phone:720-260-3401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN-77411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO99678535Medicaid
CO268642OtherUNITED CONCORDIA