Andre Barbisan De Souza, DMD Valid NPI
Individual provider · Prosthodontics · Boston, MA
- NPI
- 1114393634
- Type
- Individual (Type 1)
- Primary specialty
- Prosthodontics (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223P0700X
- License number
- DF11685 (MA)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2015-08-19
- Last updated
- 2021-05-19
Practice location
1 Kneeland St Rm 1248
Boston, MA 02111-1527
(617) 336-3467