Provider Demographics
NPI:1629297882
Name:SYLVA, LARRY ALDEN (DDS,MSCD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:ALDEN
Last Name:SYLVA
Suffix:
Gender:M
Credentials:DDS,MSCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 TARA HILLS DR STE 206
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2526
Mailing Address - Country:US
Mailing Address - Phone:510-724-4900
Mailing Address - Fax:510-724-7417
Practice Address - Street 1:1500 TARA HILLS DR STE 206
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2526
Practice Address - Country:US
Practice Address - Phone:510-724-4900
Practice Address - Fax:510-724-7417
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301541223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics