Provider Demographics
NPI:1386846350
Name:DAVID SILVERSTROM DDS PA
Entity Type:Organization
Organization Name:DAVID SILVERSTROM DDS PA
Other - Org Name:THE SILVERSTROM GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVERSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-992-3990
Mailing Address - Street 1:580 S LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5411
Mailing Address - Country:US
Mailing Address - Phone:973-992-3990
Mailing Address - Fax:
Practice Address - Street 1:580 S LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5411
Practice Address - Country:US
Practice Address - Phone:973-992-3990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ12880122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty