MEDICARE: ANDREA SILVESTRI DDS

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
1	122300000X	Dentist	15537	TX

General Provider Information

NPI Number	:	1518209345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA SILVESTRI DDS

Provider Business Mailing Address
First Line	:	5205 BROADWAY AVE
Second Line	:
City	:	HALTOM CITY
State	:	TX
Zip	:	76117-3729
Country	:	US
Telephone Number	:	817-834-3666
Fax Number	:	817-222-0730

Provider Business Practice Location Address
First Line	:	5205 BROADWAY AVE
Second Line	:
City	:	HALTOM CITY
State	:	TX
Zip	:	76117-3729
Country	:	US
Telephone Number	:	817-834-3666
Fax Number	:	817-222-0730

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2013
Last Update Date	:	03/19/2013

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