Silver Lake Dental Pllc

NPI #1518265172 in Perry, New York

Provider Information

NPI Number: 1518265172
Entity Type: Organization
Organization Name: Silver Lake Dental Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 7, 2011
Last Updated: Mar 7, 2011

Practice Location

Address: 114 N CENTER ST
City: Perry
State: New York
ZIP Code: 14530-9701
Phone: (585) 237-3530

Authorized Official

Name: DR. TIMOTHY J DERUYTER, DDS
Title: MEMBER
Phone: (315) 573-5031

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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