Provider Demographics
NPI:1417369455
Name:SILVA, MARCELO M (DDS)
Entity Type:Individual
Prefix:
First Name:MARCELO
Middle Name:M
Last Name:SILVA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 W 9TH ST
Mailing Address - Street 2:APT 329
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-1640
Mailing Address - Country:US
Mailing Address - Phone:404-488-7942
Mailing Address - Fax:
Practice Address - Street 1:645 W 9TH ST
Practice Address - Street 2:APT 329
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-1640
Practice Address - Country:US
Practice Address - Phone:404-488-7942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-26
Last Update Date:2014-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program