Provider Demographics
NPI:1669697702
Name:DEFELICE, SAVARE J III (DDS)
Entity type:Individual
Prefix:DR
First Name:SAVARE
Middle Name:J
Last Name:DEFELICE
Suffix:III
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 1:1817 GIUFFRIAS AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-2523
Mailing Address - Country:US
Mailing Address - Phone:504-258-8439
Mailing Address - Fax:
Practice Address - Street 1:7931 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1208
Practice Address - Country:US
Practice Address - Phone:225-927-3442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA 5676122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist