Provider Demographics
NPI:1275143489
Name:SAVAGE, ROSS (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 E LITTLE CREEK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-2645
Mailing Address - Country:US
Mailing Address - Phone:757-583-2333
Mailing Address - Fax:
Practice Address - Street 1:302 E LITTLE CREEK RD STE 300
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-2645
Practice Address - Country:US
Practice Address - Phone:757-583-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014152961223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics