Provider Demographics
NPI:1124043369
Name:SILSTON, STEPEHN MICHAEL (DD)
Entity Type:Individual
Prefix:
First Name:STEPEHN
Middle Name:MICHAEL
Last Name:SILSTON
Suffix:
Gender:M
Credentials:DD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 STONY HILL RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-1063
Mailing Address - Country:US
Mailing Address - Phone:203-792-2263
Mailing Address - Fax:
Practice Address - Street 1:2 STONY HILL RD
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-1063
Practice Address - Country:US
Practice Address - Phone:203-792-2263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46491223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics