Provider Demographics
NPI:1992873913
Name:DSOUZA, PREETI (DDS)
Entity type:Individual
Prefix:DR
First Name:PREETI
Middle Name:
Last Name:DSOUZA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WINGED FOOT CT
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-3922
Mailing Address - Country:US
Mailing Address - Phone:925-479-0725
Mailing Address - Fax:
Practice Address - Street 1:1821 CONCORD AVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2348
Practice Address - Country:US
Practice Address - Phone:925-825-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53777122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist