Provider Demographics
NPI:1568806388
Name:DWC-SAV, LLC
Entity Type:Organization
Organization Name:DWC-SAV, LLC
Other - Org Name:DENTAL WELLNESS CENTER OF SAVANNAH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:TROUT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:912-445-5337
Mailing Address - Street 1:10104 FORD AVE STE G
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-8849
Mailing Address - Country:US
Mailing Address - Phone:912-445-5337
Mailing Address - Fax:
Practice Address - Street 1:14045 ABERCORN ST
Practice Address - Street 2:SUITE 2403
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1957
Practice Address - Country:US
Practice Address - Phone:912-445-5337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHTDMD, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10747122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty