Provider Demographics
NPI:1609056688
Name:CARY L SAVAGE JR DDS PC
Entity Type:Organization
Organization Name:CARY L SAVAGE JR DDS PC
Other - Org Name:PEMBROKE FAMILY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-499-3522
Mailing Address - Street 1:4400 CORPORATION LANE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3109
Mailing Address - Country:US
Mailing Address - Phone:757-499-3522
Mailing Address - Fax:757-497-1022
Practice Address - Street 1:4400 CORPORATION LANE
Practice Address - Street 2:SUITE 101
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3109
Practice Address - Country:US
Practice Address - Phone:757-499-3522
Practice Address - Fax:757-497-1022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty