DR. Modupe Mary Ogunnusi Sofuye, DMD

NPI #1437644549 in South Bend, Indiana

Provider Information

NPI Number: 1437644549
Entity Type: Individual
Name: DR. Modupe Mary Ogunnusi Sofuye, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Jun 30, 2018
Last Updated: Jun 30, 2018

Practice Location

Address: 1290 E IRELAND RD
City: South Bend
State: Indiana
ZIP Code: 46614-3474
Phone: (574) 299-1400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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