MEDICARE: SAACHI GOYAL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN21729	FL

General Provider Information

NPI Number	:	1467811356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAACHI GOYAL DDS

Provider Business Mailing Address
First Line	:	6 ROCKCLIFF LANDING NW
Second Line	:
City	:	CALGARY
State	:	ALBERTA
Zip	:	T3G5Z6
Country	:	CA
Telephone Number	:	403-604-2656
Fax Number	:

Provider Business Practice Location Address
First Line	:	3756 US HIGHWAY 98 N
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33809-3809
Country	:	US
Telephone Number	:	863-286-0380
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2016
Last Update Date	:	02/19/2016

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