Healthcare Provider Details

I. General information

NPI: 1003034596
Provider Name (Legal Business Name): DAVID & JANE SILK DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 04/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 SOM CENTER RD
SOLON OH
44139-2944
US

IV. Provider business mailing address

6200 SOM CENTER RD
SOLON OH
44139-2944
US

V. Phone/Fax

Practice location:
  • Phone: 440-248-6699
  • Fax:
Mailing address:
  • Phone: 440-248-6699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number16492
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number16523
License Number StateOH

VIII. Authorized Official

Name: DR. JANE ANN SILK
Title or Position: OWNER
Credential:
Phone: 440-248-6699