MEDICARE: SILVER DENTAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	13714	NJ

General Provider Information

NPI Number	:	1972728012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVER DENTAL GROUP

Provider Business Mailing Address
First Line	:	621 WHITE HORSE PIKE
Second Line	:
City	:	HADDON TWP
State	:	NJ
Zip	:	08107-1219
Country	:	US
Telephone Number	:	856-854-4354
Fax Number	:	856-854-9599

Provider Business Practice Location Address
First Line	:	621 WHITE HORSE PIKE
Second Line	:
City	:	HADDON TWP
State	:	NJ
Zip	:	08107-1219
Country	:	US
Telephone Number	:	856-854-4354
Fax Number	:	856-854-9599

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SCOTT A SILVER
Credential	:	DMD
Telephone Number	:	856-854-4354

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	08/22/2020

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