Provider Demographics
NPI:1912211947
Name:DAVID SILVERGLADE DDS INC
Entity Type:Organization
Organization Name:DAVID SILVERGLADE DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:SILVERGLADE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-868-9804
Mailing Address - Street 1:6499 E. BROAD STREET
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213
Mailing Address - Country:US
Mailing Address - Phone:614-868-9804
Mailing Address - Fax:614-868-5084
Practice Address - Street 1:6499 E. BROAD SR
Practice Address - Street 2:SUITE 110
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213
Practice Address - Country:US
Practice Address - Phone:614-868-9804
Practice Address - Fax:614-868-5084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-02
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-14734261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center