Provider Demographics
NPI:1760568810
Name:IAFRATE SILVESTRI, ROSALIE (DDS)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:
Last Name:IAFRATE SILVESTRI
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 1:924 ROUTE 10
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869
Mailing Address - Country:US
Mailing Address - Phone:973-584-0008
Mailing Address - Fax:973-584-5663
Practice Address - Street 1:924 ROUTE 10
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869
Practice Address - Country:US
Practice Address - Phone:973-584-0008
Practice Address - Fax:973-584-5663
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2015-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 019005001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ200849061Medicare UPIN