Healthcare Provider Details

I. General information

NPI: 1003516709
Provider Name (Legal Business Name): RICARDO SOSA SILVA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2023
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 W US HIGHWAY 50
PUEBLO CO
81008-1603
US

IV. Provider business mailing address

106 BELAIRE DR APT 3B
LAREDO TX
78041-2302
US

V. Phone/Fax

Practice location:
  • Phone: 719-542-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN.00206745
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: