Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 64377 | CA |
Y | 1223P0221X | Pediatric Dentist | 64377 | CA |
NPI | 1053843847 |
---|---|
Provider Name | Dr. Sarah Silverstein |
First Address | La Mesa, CA 91942-2573 |
Second Address | Chula Vista, CA 91910-6912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2017 |
Last Update Date | 10/09/2018 |