# SUJATHA H DE SILVA DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871564054
- **Authorized official:** SUJATHA H DE SILVA DDS (PRINCIPAL)
- **Authorized official phone:** (718) 556-5432

## Contact information

- **Practice address:** 973 TARGEE STREET, STATEN ISLAND, NY 10304
- **Practice address phone:** (718) 556-5432
- **Practice address fax:** (718) 556-5432
- **Mailing address:** 973 TARGEE STREET, STATEN ISLAND, NY 10304
- **Mailing address phone:** (718) 556-5432
- **Mailing address fax:** (718) 556-5432

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/27/2006
- **Last updated:** 08/25/2009