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General NPI Number Information
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NPI Number | 1366501579
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Entity Type | Organization
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Legal Business Name | SILVIA T. BORISSON D.D.S., INC
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4654 E AVENUE S SUITE A
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City | PALMDALE
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State | CA
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Zip | 93552-4454
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Country | US
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Telephone | 661-285-4001
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Fax | 661-285-2282
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Provider Business Mailing Address
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Address Line | 4654 E AVENUE S SUITE A
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City | PALMDALE
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State | CA
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Zip | 93552-4454
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Country | US
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Telephone | 661-285-4001
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Fax | 661-285-2282
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SILVIA T BORISSON
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Credential | D.D.S
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Telephone | 661-285-4001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 49280
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License Number State | CA
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