Provider Demographics
NPI:1134487044
Name:DSOUZA, AVRIL (DMD)
Entity Type:Individual
Prefix:DR
First Name:AVRIL
Middle Name:
Last Name:DSOUZA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 FRANKLIN ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-2100
Mailing Address - Country:US
Mailing Address - Phone:518-346-5338
Mailing Address - Fax:
Practice Address - Street 1:600 FRANKLIN ST
Practice Address - Street 2:SUITE 114
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12305-2100
Practice Address - Country:US
Practice Address - Phone:518-346-5338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046358122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist