Provider Demographics
NPI:1114134426
Name:SILVA FAMILY DENTISTRY
Entity Type:Organization
Organization Name:SILVA FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-569-9250
Mailing Address - Street 1:PO BOX 2119
Mailing Address - Street 2:
Mailing Address - City:WOLFEBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03894-2119
Mailing Address - Country:US
Mailing Address - Phone:603-569-9250
Mailing Address - Fax:603-569-9298
Practice Address - Street 1:16 LEHNER STREET
Practice Address - Street 2:
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894
Practice Address - Country:US
Practice Address - Phone:603-569-9250
Practice Address - Fax:603-569-9298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH33611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1655865OtherUNITED CONCORDIA CO.,INC.
NH30313192Medicare ID - Type UnspecifiedHEALTHY KIDS GOLD