Provider Demographics
NPI:1164636031
Name:WILLIAM R. GOULD, D.D.S., L.L.C.
Entity Type:Organization
Organization Name:WILLIAM R. GOULD, D.D.S., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:207-454-2350
Mailing Address - Street 1:581 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-1831
Mailing Address - Country:US
Mailing Address - Phone:207-454-3469
Mailing Address - Fax:207-454-2879
Practice Address - Street 1:399 MAIN ST
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-1859
Practice Address - Country:US
Practice Address - Phone:207-454-2350
Practice Address - Fax:207-454-2879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2149122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty