Organization
SUJATHA H DE SILVA DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUJATHA H DE SILVA DDS (PRINCIPAL)
(845) 856-4002
Entity
Organization
Contact information
Practice address
141 PIKE STREET, PORT JERVIS, NY 12771
(845) 856-4002
(845) 856-4002
Mailing address
141 PIKE STREET, PORT JERVIS, NY 12771
(845) 856-4002
(845) 856-4002
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00946341
—
NY
Enumeration date
01/27/2006
Last updated
08/11/2009
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