MEDICARE: DR. MARK J SILVERS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	18717	OH

General Provider Information

NPI Number	:	1437367893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK J SILVERS DDS

Provider Business Mailing Address
First Line	:	2750 BLACKBIRD HOLW
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45244-3589
Country	:	US
Telephone Number	:	513-231-3246
Fax Number	:

Provider Business Practice Location Address
First Line	:	7710 SHAWNEE RUN RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45243-3176
Country	:	US
Telephone Number	:	513-271-1101
Fax Number	:	513-271-5014

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	07/08/2007

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