Provider Demographics
NPI:1609220474
Name:SILSBY FAMILY DENTAL, PLLC
Entity Type:Organization
Organization Name:SILSBY FAMILY DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SILSBY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-870-1802
Mailing Address - Street 1:6984 RUSH LIMA RD
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-9006
Mailing Address - Country:US
Mailing Address - Phone:716-870-1802
Mailing Address - Fax:
Practice Address - Street 1:313 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NY
Practice Address - Zip Code:14411-1602
Practice Address - Country:US
Practice Address - Phone:716-870-1802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0573881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty