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General NPI Number Information
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NPI Number | 1235260688
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Entity Type | Organization
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Legal Business Name | SURESH N GOEL DDS PC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 151 SULLYS TRL PROGRESSIVE IMPLANTOLOGY & PERIODONTICS
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City | PITTSFORD
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State | NY
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Zip | 14534-4562
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Country | US
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Telephone | 585-385-4867
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Fax | 585-385-4914
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Provider Business Mailing Address
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Address Line | 151 SULLYS TRL PROGRESSIVE IMPLANTOLOGY & PERIODONTICS
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City | PITTSFORD
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State | NY
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Zip | 14534-4562
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Country | US
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Telephone | 585-385-4867
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Fax | 585-385-4914
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SURESH NAIRN GOEL
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Credential | DDS, MS
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Telephone | 585-385-4867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 051108
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License Number State | NY
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