Provider Demographics
NPI:1285791913
Name:SILVERSTEIN, SCOTT IVAN (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:IVAN
Last Name:SILVERSTEIN
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 STATE ROUTE 28
Mailing Address - Street 2:SUITE A
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1802
Mailing Address - Country:US
Mailing Address - Phone:513-248-2626
Mailing Address - Fax:513-248-8659
Practice Address - Street 1:748 STATE ROUTE 28
Practice Address - Street 2:SUITE A
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1802
Practice Address - Country:US
Practice Address - Phone:513-248-2626
Practice Address - Fax:513-248-8659
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH190451223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics