Provider Demographics
NPI:1336359496
Name:SAVEDRA, MANUEL ANGEL (DDS)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:ANGEL
Last Name:SAVEDRA
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 1:731 SEADRIFT DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-4163
Mailing Address - Country:US
Mailing Address - Phone:714-536-6877
Mailing Address - Fax:
Practice Address - Street 1:4332 SLAUSON AVE
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90270-2848
Practice Address - Country:US
Practice Address - Phone:323-771-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA242021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice