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General NPI Number Information
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NPI Number | 1093602591
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Entity Type | Individual
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Provider Name | MARIA SOUS DMD
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Gender | Female
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 214 NEW RD
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City | LINWOOD
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State | NJ
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Zip | 08221-1214
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Country | US
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Telephone | 609-653-0980
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Fax |
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Provider Business Mailing Address
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Address Line | 1610 STEVENS ST
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City | EAST PETERSBURG
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State | PA
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Zip | 17520-1142
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Country | US
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Telephone | 717-940-5047
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI03099700
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License Number State | NJ
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