Healthcare Provider Details

I. General information

NPI: 1811082183
Provider Name (Legal Business Name): LEE HOWARD SILVERSTEIN D.D.S., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2070 S PARK PL SE SUITE 200
ATLANTA GA
30339-2045
US

IV. Provider business mailing address

2070 S PARK PL SE SUITE 200
ATLANTA GA
30339-2045
US

V. Phone/Fax

Practice location:
  • Phone: 770-952-5432
  • Fax: 770-952-3011
Mailing address:
  • Phone: 770-952-5432
  • Fax: 770-952-3011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number10742
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: