Provider Demographics
NPI:1942326145
Name:SAVAGE, DENNIS KEITH (DDS)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:KEITH
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 1:4102 BUFFALO GAP RD
Mailing Address - Street 2:STE. L
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-7248
Mailing Address - Country:US
Mailing Address - Phone:325-695-2015
Mailing Address - Fax:325-695-2015
Practice Address - Street 1:4102 BUFFALO GAP RD
Practice Address - Street 2:STE. L
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-7248
Practice Address - Country:US
Practice Address - Phone:325-695-2015
Practice Address - Fax:325-695-2015
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD12495OtherBLUE CROSS BLUE SHIELD #
TX787389OtherUNITED CONCORDIA PROVIDER