Provider Demographics
NPI:1407059041
Name:SAFFRO, DENNIS W (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:W
Last Name:SAFFRO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9735 WILSHIRE BOULEVARD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2111
Mailing Address - Country:US
Mailing Address - Phone:310-246-9927
Mailing Address - Fax:310-246-9932
Practice Address - Street 1:9735 WILSHIRE BOULEVARD
Practice Address - Street 2:SUITE 320
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2111
Practice Address - Country:US
Practice Address - Phone:310-246-9927
Practice Address - Fax:310-246-9932
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA199651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice