Healthcare Provider Details

I. General information

NPI: 1205019585
Provider Name (Legal Business Name): JAMES D SAVAGE D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 12/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 E MCANDREWS RD # A
MEDFORD OR
97504-5334
US

IV. Provider business mailing address

1625 E MCANDREWS RD # A
MEDFORD OR
97504-5334
US

V. Phone/Fax

Practice location:
  • Phone: 541-779-3781
  • Fax: 541-779-6523
Mailing address:
  • Phone: 541-779-3781
  • Fax: 541-779-6523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number7614
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: