Provider Demographics
NPI:1689291494
Name:PUETT, SAVANNAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAVANNAH
Middle Name:
Last Name:PUETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4739 MOUNT HARRIS DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-3908
Mailing Address - Country:US
Mailing Address - Phone:910-520-5106
Mailing Address - Fax:
Practice Address - Street 1:8600 LA MESA BLVD STE A
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-9572
Practice Address - Country:US
Practice Address - Phone:619-465-1990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109236122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist