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General NPI Number Information
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NPI Number | 1780711481
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Entity Type | Organization
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Legal Business Name | DOVER FOOT SPECIALTY CENTER, PC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 10/20/2008
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Provider Practice Location Address
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Address Line | 750 CENTRAL AVE SUITE J
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City | DOVER
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State | NH
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Zip | 03820-3434
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Country | US
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Telephone | 603-742-2245
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Fax | 603-742-0712
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Provider Business Mailing Address
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Address Line | 750 CENTRAL AVE SUITE J
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City | DOVER
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State | NH
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Zip | 03820-3434
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Country | US
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Telephone | 603-742-2245
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Fax | 603-742-0712
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Authorized Official
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Title or Position | CEO
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Name | WAYNE C GOULD
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Credential | DPM
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Telephone | 603-742-2245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0187
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License Number State | NH
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