Healthcare Provider Details

I. General information

NPI: 1134587934
Provider Name (Legal Business Name): ERIC SILVER DMD, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2016
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 CLARKSON AVE
BROOKLYN NY
11203-2054
US

IV. Provider business mailing address

451 CLARKSON AVE E-1106
BROOKLYN NY
11203-2054
US

V. Phone/Fax

Practice location:
  • Phone: 718-245-2299
  • Fax:
Mailing address:
  • Phone: 718-245-2299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberDS043554
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: