Provider Demographics
NPI:1558531483
Name:BORISSON, SILVIA T (DDS)
Entity Type:Individual
Prefix:DR
First Name:SILVIA
Middle Name:T
Last Name:BORISSON
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 1:4654 E AVENUE S STE A
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-4454
Mailing Address - Country:US
Mailing Address - Phone:661-285-4001
Mailing Address - Fax:661-285-2282
Practice Address - Street 1:4654 E AVENUE S STE A
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552-4454
Practice Address - Country:US
Practice Address - Phone:661-285-4001
Practice Address - Fax:661-285-2282
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49280122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93053-01OtherDENTI-CAL