Provider Demographics
NPI:1235923103
Name:BROOME, SAVANNAH (DMD)
Entity type:Individual
Prefix:DR
First Name:SAVANNAH
Middle Name:
Last Name:BROOME
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 1:30 W MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:MONUMENT VALLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84536-7705
Mailing Address - Country:US
Mailing Address - Phone:435-727-3000
Mailing Address - Fax:
Practice Address - Street 1:30 W MEDICAL DR
Practice Address - Street 2:
Practice Address - City:MONUMENT VALLEY
Practice Address - State:UT
Practice Address - Zip Code:84536-7705
Practice Address - Country:US
Practice Address - Phone:435-727-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14211256-9926122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist