| Sujatha H De Silva Dds Pc | |
|
973 Targee Street Staten Island NY 10304 | |
| (718) 556-5432 | |
| (718) 556-5432 |
| Full Name | Sujatha H De Silva Dds Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 973 Targee Street, Staten Island, New York |
| Authorized Official Name and Position | Sujatha H De Silva (PRINCIPAL) |
| Authorized Official Contact | 7185565432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sujatha H De Silva Dds Pc 973 Targee Street Staten Island NY 10304 Ph: (718) 556-5432 | Sujatha H De Silva Dds Pc 973 Targee Street Staten Island NY 10304 Ph: (718) 556-5432 |
| NPI Number | 1871564054 |
|---|---|
| Provider Enumeration Date | 01/27/2006 |
| Last Update Date | 08/25/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871564054 | NPI | - | NPPES |
| 00946341 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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