Provider Demographics
NPI:1659732824
Name:DA SILVA, FREDERICO DUARTE (DDS)
Entity Type:Individual
Prefix:
First Name:FREDERICO
Middle Name:DUARTE
Last Name:DA 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 1:7809 IOLA DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-2822
Mailing Address - Country:US
Mailing Address - Phone:352-999-4866
Mailing Address - Fax:
Practice Address - Street 1:7809 IOLA DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-2822
Practice Address - Country:US
Practice Address - Phone:352-999-4866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-15
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX357071223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics