Provider Demographics
NPI:1346314150
Name:SAVAGE, ELTON DEVIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELTON
Middle Name:DEVIN
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 1:134 1/2 BROADWAY E
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-1304
Mailing Address - Country:US
Mailing Address - Phone:740-920-4124
Mailing Address - Fax:
Practice Address - Street 1:21 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-1076
Practice Address - Country:US
Practice Address - Phone:740-920-4124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21467122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist