Healthcare Provider Details

I. General information

NPI: 1053653428
Provider Name (Legal Business Name): PHILIP BHASKAR DMD & PERRY SILVA DDS MD ORAL & MAXILLOFACIAL SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2013
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 EL DORADO ST SUITE 3
MONTEREY CA
93940-4625
US

IV. Provider business mailing address

335 EL DORADO ST SUITE 3
MONTEREY CA
93940-4625
US

V. Phone/Fax

Practice location:
  • Phone: 831-372-2882
  • Fax: 831-372-9241
Mailing address:
  • Phone: 831-372-2882
  • Fax: 831-372-9241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number37504
License Number StateCA

VIII. Authorized Official

Name: DR. PERRY V SILVA
Title or Position: PARTNER
Credential: DDS, MD
Phone: 831-372-2882