Provider Demographics
NPI:1770572901
Name:SILVA, LUIS D (DMD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:D
Last Name:SILVA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 AVE BARBOSA
Mailing Address - Street 2:HATO REY
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-3314
Mailing Address - Country:US
Mailing Address - Phone:787-753-1532
Mailing Address - Fax:787-760-1684
Practice Address - Street 1:321 AVE BARBOSA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3314
Practice Address - Country:US
Practice Address - Phone:787-753-1532
Practice Address - Fax:787-760-1684
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1162122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist