Healthcare Provider Details

I. General information

NPI: 1073864476
Provider Name (Legal Business Name): LESLIE SILVERMAN KOPSTEIN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LESLIE SILVERMAN DDS

II. Dates (important events)

Enumeration Date: 09/25/2012
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 SUTTER ST RM 1610
SAN FRANCISCO CA
94108-4005
US

IV. Provider business mailing address

450 SUTTER ST RM 1610
SAN FRANCISCO CA
94108-4005
US

V. Phone/Fax

Practice location:
  • Phone: 415-233-4402
  • Fax:
Mailing address:
  • Phone: 415-233-4402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number46685
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: