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General NPI Number Information
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NPI Number | 1174247951
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Entity Type | Organization
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Legal Business Name | KEITH SILVERSTEIN ORAL & MAXILLOFACIAL SURGERY, PC
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Dates
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Enumeration Date | 09/27/2022
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Last Update Date | 09/27/2022
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Provider Practice Location Address
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Address Line | 21 INDUSTRIAL BLVD STE 100
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City | PAOLI
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State | PA
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Zip | 19301-1610
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Country | US
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Telephone | 610-644-6497
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Fax |
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Provider Business Mailing Address
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Address Line | 21 INDUSTRIAL BLVD STE 100
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City | PAOLI
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State | PA
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Zip | 19301-1610
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Country | US
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Telephone | 610-644-6497
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Fax |
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Authorized Official
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Title or Position | ORAL SURGEON
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Name | KEITH SILVERSTEIN
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Credential | DMD, MD
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Telephone | 610-644-6497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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