| Sujatha H De Silva Dds Pc | |
|
141 Pike Street Port Jervis NY 12771 | |
| (845) 856-4002 | |
| (845) 856-4002 |
| Full Name | Sujatha H De Silva Dds Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 141 Pike Street, Port Jervis, New York |
| Authorized Official Name and Position | Sujatha H De Silva (PRINCIPAL) |
| Authorized Official Contact | 8458564002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sujatha H De Silva Dds Pc 141 Pike Street Port Jervis NY 12771 Ph: (845) 856-4002 | Sujatha H De Silva Dds Pc 141 Pike Street Port Jervis NY 12771 Ph: (845) 856-4002 |
| NPI Number | 1447221627 |
|---|---|
| Provider Enumeration Date | 01/27/2006 |
| Last Update Date | 08/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447221627 | NPI | - | NPPES |
| 00946341 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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