=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417087693
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KRISTIN M. SAVILLE, DDS, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/06/2007
-----------------------------------------------------
Last Update Date | 05/18/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2060 CHARLIE HALL BLVD SUITE B
-----------------------------------------------------
City | CHARLESTON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29414-5830
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-766-0266
-----------------------------------------------------
Fax | 843-766-0849
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2060 CHARLIE HALL BLVD SUITE B
-----------------------------------------------------
City | CHARLESTON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29414-5830
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-766-0266
-----------------------------------------------------
Fax | 843-766-0849
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. KRISTIN M SAVILLE
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 843-766-0266
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 3607
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------