Healthcare Provider Details

I. General information

NPI: 1053458422
Provider Name (Legal Business Name): ALEXANDER ZILBERMAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10108 BUSTLETON AVE
PHILADELPHIA PA
19116-3704
US

IV. Provider business mailing address

2733 SUNFLOWER WAY
HUNTINGDON VALLEY PA
19006-5443
US

V. Phone/Fax

Practice location:
  • Phone: 215-677-3904
  • Fax: 215-677-2401
Mailing address:
  • Phone: 267-934-6551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS035265L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: