Provider Demographics
NPI:1093864811
Name:GOLI, RADHIKA (DMD)
Entity Type:Individual
Prefix:DR
First Name:RADHIKA
Middle Name:
Last Name:GOLI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CURREN DR
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-1182
Mailing Address - Country:US
Mailing Address - Phone:978-392-9955
Mailing Address - Fax:
Practice Address - Street 1:157 MAIN DUNSTABLE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3641
Practice Address - Country:US
Practice Address - Phone:603-886-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH33311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice