Provider Demographics
NPI:1285018242
Name:SAVARDI, CAMILLA SUNNY (DMD)
Entity type:Individual
Prefix:
First Name:CAMILLA
Middle Name:SUNNY
Last Name:SAVARDI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 JOHN KNOX RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-6643
Mailing Address - Country:US
Mailing Address - Phone:850-386-5174
Mailing Address - Fax:
Practice Address - Street 1:210 JOHN KNOX RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-6643
Practice Address - Country:US
Practice Address - Phone:850-386-5174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-18
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN214551223G0001X
FL21455122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice