Provider Demographics
NPI:1932116068
Name:DA SILVA, JOHN DAREN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAREN
Last Name:DA SILVA
Suffix:
Gender:M
Credentials:DMD
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Mailing Address - Street 1:196 CHESTNUT AVE
Mailing Address - Street 2:UNIT M
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4446
Mailing Address - Country:US
Mailing Address - Phone:617-432-1440
Mailing Address - Fax:617-432-3881
Practice Address - Street 1:188 LONGWOOD AVE
Practice Address - Street 2:SUITE 206F
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5819
Practice Address - Country:US
Practice Address - Phone:617-432-1440
Practice Address - Fax:617-432-3881
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA164841223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics