Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 401006285 | VA |
NPI | 1053708461 |
---|---|
Provider Name | Dr. Anthony Walter Savage |
First Address | Virgina Beach, VA 23451-6177 |
Second Address | Virgina Beach, VA 23451-6177 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2015 |
Last Update Date | 23/04/2015 |