Healthcare Provider Details

I. General information

NPI: 1124300306
Provider Name (Legal Business Name): ERIC FRANCIS D'SILVA DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 01/21/2023
Certification Date: 01/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 MATTHEWS TOWNSHIP PKWY STE 101
MATTHEWS NC
28105-4682
US

IV. Provider business mailing address

1320 MATTHEWS TOWNSHIP PKWY STE 101
MATTHEWS NC
28105-4682
US

V. Phone/Fax

Practice location:
  • Phone: 704-246-7241
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number10929
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: