Provider Demographics
NPI:1255843066
Name:SAVINO, DEBORAH JO (DH)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:JO
Last Name:SAVINO
Suffix:
Gender:F
Credentials:DH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 375
Mailing Address - Street 2:850 MAIN ST
Mailing Address - City:COALPORT
Mailing Address - State:PA
Mailing Address - Zip Code:16627-0375
Mailing Address - Country:US
Mailing Address - Phone:817-672-5480
Mailing Address - Fax:814-672-5778
Practice Address - Street 1:850 MAIN STREET
Practice Address - Street 2:
Practice Address - City:COALPORT
Practice Address - State:PA
Practice Address - Zip Code:16627-0375
Practice Address - Country:US
Practice Address - Phone:814-672-5480
Practice Address - Fax:814-672-5778
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH012991L124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist