Provider Demographics
NPI:1851396733
Name:SYLVESTER, MARK RALPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:RALPH
Last Name:SYLVESTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25500 DARIO TER
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-5630
Mailing Address - Country:US
Mailing Address - Phone:510-538-2395
Mailing Address - Fax:
Practice Address - Street 1:1680 B ST
Practice Address - Street 2:STE A
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-3040
Practice Address - Country:US
Practice Address - Phone:510-581-8366
Practice Address - Fax:510-581-8382
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice