Provider Demographics
NPI:1952338618
Name:SAVAGE, ANTHONY H (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:H
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:306 WALNUT AVE
Mailing Address - Street 2:SUITE 33
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-4978
Mailing Address - Country:US
Mailing Address - Phone:619-295-3456
Mailing Address - Fax:619-295-3411
Practice Address - Street 1:306 WALNUT AVE
Practice Address - Street 2:SUITE 33
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4978
Practice Address - Country:US
Practice Address - Phone:619-295-3456
Practice Address - Fax:619-295-3411
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA252871223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA25287OtherCA DENTAL STATE LICENSE #
CA484055OtherUNITED CONCORDIA USER ID