MEDICARE: DR. GAURI GOYAL PATEL 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	019027322	IL
2	122300000X	Dentist	6304-15	WI

General Provider Information

NPI Number	:	1942468848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAURI GOYAL PATEL DDS

Provider Business Mailing Address
First Line	:	400 E SILVER SPRING DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53217-5224
Country	:	US
Telephone Number	:	414-332-6010
Fax Number	:	414-322-1850

Provider Business Practice Location Address
First Line	:	400 E SILVER SPRING DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53217-5224
Country	:	US
Telephone Number	:	414-332-6010
Fax Number	:	414-322-1850

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

Provider Enumeration Date	:	05/28/2008
Last Update Date	:	09/08/2020

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Directions to “ DR. GAURI GOYAL PATEL DDS” Practice Location

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