MEDICARE: DR. MASON A SAVAGE D.D.S.

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	1970	HI
2	1223G0001X	General Practice Dentistry	43560	CA

General Provider Information

NPI Number	:	1285790477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MASON A SAVAGE D.D.S.

Provider Business Mailing Address
First Line	:	4211 WAIALAE AVE STE 210
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-5312
Country	:	US
Telephone Number	:	808-734-5671
Fax Number	:	808-734-4661

Provider Business Practice Location Address
First Line	:	4211 WAIALAE AVE STE 210
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-5312
Country	:	US
Telephone Number	:	808-734-5671
Fax Number	:	808-734-4661

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	12/31/2014

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