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NPI Code Detail

MEDICARE: DERRICK SILVA

MEDICARE: DERRICK SILVA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry30.025810OH

General Provider Information

NPI Number : 1073172839
Entity Type Code : Individual
Provider Name (Legal Business Name) : DERRICK SILVA
Provider Business Mailing Address
First Line : 2046 CUMMINGS AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43609-1906
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 875 WESTMORELAND AVE
Second Line :
City : NAPOLEON
State : OH
Zip : 43545-1260
Country : US
Telephone Number : 887-216-9296
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2019
Last Update Date : 06/06/2019

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Directions to “ DERRICK SILVA ” Practice Location

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