Provider Demographics
NPI:1285790477
Name:SAVAGE, MASON A (DDS)
Entity type:Individual
Prefix:DR
First Name:MASON
Middle Name:A
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 WAIALAE AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5312
Mailing Address - Country:US
Mailing Address - Phone:808-734-5671
Mailing Address - Fax:808-734-4661
Practice Address - Street 1:4211 WAIALAE AVE STE 210
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5312
Practice Address - Country:US
Practice Address - Phone:808-734-5671
Practice Address - Fax:808-734-4661
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI19701223G0001X
CA435601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice