MEDICARE: KRISTIN M. SAVILLE, DDS, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3607	SC

General Provider Information

NPI Number	:	1417087693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRISTIN M. SAVILLE, DDS, PC

Provider Business Mailing Address
First Line	:	2060 CHARLIE HALL BLVD
Second Line	:	SUITE B
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5830
Country	:	US
Telephone Number	:	843-766-0266
Fax Number	:	843-766-0849

Provider Business Practice Location Address
First Line	:	2060 CHARLIE HALL BLVD
Second Line	:	SUITE B
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5830
Country	:	US
Telephone Number	:	843-766-0266
Fax Number	:	843-766-0849

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KRISTIN M SAVILLE
Credential	:	DDS
Telephone Number	:	843-766-0266

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	05/18/2010

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