Provider Demographics
NPI:1366733487
Name:SILFA, PUBLIO (DDS)
Entity type:Individual
Prefix:
First Name:PUBLIO
Middle Name:
Last Name:SILFA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3080 21ST ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-4242
Mailing Address - Country:US
Mailing Address - Phone:718-873-9550
Mailing Address - Fax:718-228-4591
Practice Address - Street 1:3080 21ST ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-4242
Practice Address - Country:US
Practice Address - Phone:718-873-9550
Practice Address - Fax:718-228-4591
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-23
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY0560711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program