Provider Demographics
NPI:1255365532
Name:SAVILLE, SUZANNE KAY (DDS)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:KAY
Last Name:SAVILLE
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:PO BOX 226
Mailing Address - Street 2:
Mailing Address - City:GUERNEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95446
Mailing Address - Country:US
Mailing Address - Phone:707-869-2933
Mailing Address - Fax:707-869-2663
Practice Address - Street 1:16312 3RD STREET
Practice Address - Street 2:
Practice Address - City:GUERNEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95446
Practice Address - Country:US
Practice Address - Phone:707-869-2933
Practice Address - Fax:707-869-2663
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60851223D0001X, 122300000X
CA63282122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public Health