Basic Information
Provider Information
NPI: 1003014614
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAAVEDRA
FirstName: ROCIO
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 304 BERKELEY ST
Address2: APT 4
City: BOSTON
State: MA
PostalCode: 021162028
CountryCode: US
TelephoneNumber: 6176949701
FaxNumber:  
Practice Location
Address1: 1 KNEELAND ST
Address2:  
City: BOSTON
State: MA
PostalCode: 021111527
CountryCode: US
TelephoneNumber: 6176366971
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/05/2007
LastUpdateDate: 02/16/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000XDL12884MAN Dental ProvidersDentist 
122300000XDL12854MAN Dental ProvidersDentist 
122300000XDL12853MAY Dental ProvidersDentist 

No ID Information.


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