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General NPI Number Information
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NPI Number | 1962662817
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Entity Type | Individual
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Provider Name | SUSAN ELIZABETH SAVOY RDH
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Gender | Female
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Dates
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Enumeration Date | 06/13/2008
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Last Update Date | 05/21/2017
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Provider Practice Location Address
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Address Line | BAVARIA DENTAL ACTIVITY CREDENTIALS OFFICE CMR 475
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City | APO
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State | AE
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Zip | 09036
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Country | US
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Telephone | 499318897714
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Fax | 499318897714
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Provider Business Mailing Address
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Address Line | 1759 VZ COUNTY ROAD 2705
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City | MABANK
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State | TX
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Zip | 75147-5483
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Country | US
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Telephone | 806-729-8781
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 4985
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License Number State | TX
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