Provider Demographics
NPI:1851459036
Name:SAVAGE, MARY ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9930 GRUBBS RD
Mailing Address - Street 2:SUITE LL40
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9643
Mailing Address - Country:US
Mailing Address - Phone:412-364-6523
Mailing Address - Fax:
Practice Address - Street 1:9930 GRUBBS RD
Practice Address - Street 2:SUITE LL40
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9643
Practice Address - Country:US
Practice Address - Phone:412-364-6523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024709L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice