Provider Demographics
NPI:1003034596
Name:DAVID & JANE SILK DDS INC
Entity Type:Organization
Organization Name:DAVID & JANE SILK DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SILK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-248-6699
Mailing Address - Street 1:6200 SOM CENTER RD
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2944
Mailing Address - Country:US
Mailing Address - Phone:440-248-6699
Mailing Address - Fax:
Practice Address - Street 1:6200 SOM CENTER RD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2944
Practice Address - Country:US
Practice Address - Phone:440-248-6699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH164921223G0001X
OH165231223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty