Provider Demographics
NPI:1558372342
Name:SALVAGGIO, GARRY S (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARRY
Middle Name:S
Last Name:SALVAGGIO
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 1:2221 TRANSCONTINENTAL DR STE C
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1046
Mailing Address - Country:US
Mailing Address - Phone:504-455-7717
Mailing Address - Fax:504-455-7591
Practice Address - Street 1:2221 TRANSCONTINENTAL DR STE C
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1046
Practice Address - Country:US
Practice Address - Phone:504-455-7717
Practice Address - Fax:504-455-7591
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA45511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4551OtherLICENSE