Provider Demographics
NPI:1548386683
Name:SILVERBERG, LISA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:SILVERBERG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17270 BOCA CLUB BLVD
Mailing Address - Street 2:#1707
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1285
Mailing Address - Country:US
Mailing Address - Phone:518-573-2050
Mailing Address - Fax:
Practice Address - Street 1:17270 BOCA CLUB BLVD
Practice Address - Street 2:17270
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1285
Practice Address - Country:US
Practice Address - Phone:518-573-2050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN177001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice