Provider Demographics
NPI:1497146070
Name:SAVOLA AESTHETIC DERMATOLOGY CENTER PLC
Entity Type:Organization
Organization Name:SAVOLA AESTHETIC DERMATOLOGY CENTER PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-249-9855
Mailing Address - Street 1:66 PARKWAY LANE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939
Mailing Address - Country:US
Mailing Address - Phone:540-451-2833
Mailing Address - Fax:540-451-2835
Practice Address - Street 1:66 PARKWAY LANE
Practice Address - Street 2:SUITE 101
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939
Practice Address - Country:US
Practice Address - Phone:540-451-2833
Practice Address - Fax:540-451-2835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty