Provider Demographics
NPI:1285150227
Name:KRIVONYAK, SAVANAH MARIE (RDH, PHDHP)
Entity type:Individual
Prefix:MS
First Name:SAVANAH
Middle Name:MARIE
Last Name:KRIVONYAK
Suffix:
Gender:F
Credentials:RDH, PHDHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 FILLMORE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857-3228
Mailing Address - Country:US
Mailing Address - Phone:814-389-3193
Mailing Address - Fax:
Practice Address - Street 1:90 E 2ND ST
Practice Address - Street 2:
Practice Address - City:EMPORIUM
Practice Address - State:PA
Practice Address - Zip Code:15834-1302
Practice Address - Country:US
Practice Address - Phone:814-486-0909
Practice Address - Fax:814-486-0425
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH072495124Q00000X
PAPHDH000919124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist