Provider Demographics
NPI:1437284346
Name:SOUSA, MANUEL JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:JOSEPH
Last Name:SOUSA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:32 STILES RD
Mailing Address - Street 2:SUTIE 211
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2892
Mailing Address - Country:US
Mailing Address - Phone:603-898-4722
Mailing Address - Fax:603-898-4966
Practice Address - Street 1:32 STILES RD
Practice Address - Street 2:SUTIE 211
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2892
Practice Address - Country:US
Practice Address - Phone:603-898-4722
Practice Address - Fax:603-898-4966
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH15091223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics