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General NPI Number Information
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NPI Number | 1689073306
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Entity Type | Organization
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Legal Business Name | JOEL DAVID GOULD, D.D.S. INC
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 05/09/2016
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Provider Practice Location Address
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Address Line | 8940 RESEDA BLVD STE 102
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City | NORTHRIDGE
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State | CA
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Zip | 91324-5834
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Country | US
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Telephone | 818-886-1012
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Fax | 818-886-4359
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Provider Business Mailing Address
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Address Line | 8940 RESEDA BLVD STE 102
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City | NORTHRIDGE
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State | CA
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Zip | 91324-5834
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Country | US
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Telephone | 818-886-1012
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Fax | 818-886-4359
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JENNIFER GUERRERA
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Credential |
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Telephone | 818-886-1012
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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 |
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License Number State | CA
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