Healthcare Provider Details

I. General information

NPI: 1083263321
Provider Name (Legal Business Name): APOORV GOEL BDS, MS, MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 DR DB TODD JR BLVD
NASHVILLE TN
37208-3501
US

IV. Provider business mailing address

319 KOEHNE ST APT 5
INDIANAPOLIS IN
46222-4315
US

V. Phone/Fax

Practice location:
  • Phone: 502-654-5457
  • Fax:
Mailing address:
  • Phone: 502-654-5457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number11129
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: