Provider Demographics
NPI:1679605273
Name:SENN, SILVANO CONSTANTINO (DDS)
Entity type:Individual
Prefix:
First Name:SILVANO
Middle Name:CONSTANTINO
Last Name:SENN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 PLEASANT HILL AVE N STE 150
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-3166
Mailing Address - Country:US
Mailing Address - Phone:707-849-5048
Mailing Address - Fax:707-823-7449
Practice Address - Street 1:120 PLEASANT HILL AVE N STE 150
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-3166
Practice Address - Country:US
Practice Address - Phone:707-849-5048
Practice Address - Fax:707-823-7449
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice