Provider Demographics
NPI:1447384003
Name:SAVAGE, SAMUEL H (DDS)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:H
Last Name:SAVAGE
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 1:223 N PECOS RD
Mailing Address - Street 2:130
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7361
Mailing Address - Country:US
Mailing Address - Phone:702-734-1100
Mailing Address - Fax:702-734-7899
Practice Address - Street 1:223 N PECOS RD
Practice Address - Street 2:130
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7361
Practice Address - Country:US
Practice Address - Phone:702-734-1100
Practice Address - Fax:702-734-7899
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2167122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist