Provider Demographics
NPI:1053750513
Name:SAVAGE, TRENT C (DMD)
Entity type:Individual
Prefix:DR
First Name:TRENT
Middle Name:C
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 GAINSBOROUGH DRIVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311
Mailing Address - Country:US
Mailing Address - Phone:850-273-6000
Mailing Address - Fax:
Practice Address - Street 1:1970 GAINSBOROUGH DRIVE
Practice Address - Street 2:SUITE 2
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32311
Practice Address - Country:US
Practice Address - Phone:850-273-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20157122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist