Provider Demographics
NPI:1679558829
Name:SAVAGE, BRYAN PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:PAUL
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 1:15530 W 64TH AVE UNIT H
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-6874
Mailing Address - Country:US
Mailing Address - Phone:303-422-3746
Mailing Address - Fax:303-422-5811
Practice Address - Street 1:15530 W 64TH AVE UNIT H
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80007-6874
Practice Address - Country:US
Practice Address - Phone:303-422-3746
Practice Address - Fax:303-422-5811
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8643122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO02926377Medicaid