Provider Demographics
NPI:1245582436
Name:LESLIE SILVERMAN DDS INC A PROF CORP
Entity Type:Organization
Organization Name:LESLIE SILVERMAN DDS INC A PROF CORP
Other - Org Name:LESLIE SILVERMAN DDS INC A PROF CORP
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-233-4402
Mailing Address - Street 1:450 SUTTER ST
Mailing Address - Street 2:SUITE 1610
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4210
Mailing Address - Country:US
Mailing Address - Phone:415-233-4402
Mailing Address - Fax:
Practice Address - Street 1:450 SUTTER ST
Practice Address - Street 2:SUITE 1610
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4210
Practice Address - Country:US
Practice Address - Phone:415-233-4402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46685122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty