Provider Demographics
NPI:1235260688
Name:SURESH N GOEL DDS PC
Entity Type:Organization
Organization Name:SURESH N GOEL DDS PC
Other - Org Name:PROGRESSIVE DENTAL SPECIALISTS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SURESH
Authorized Official - Middle Name:NAIRN
Authorized Official - Last Name:GOEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:585-385-4867
Mailing Address - Street 1:151 SULLYS TRL
Mailing Address - Street 2:PROGRESSIVE IMPLANTOLOGY & PERIODONTICS
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4562
Mailing Address - Country:US
Mailing Address - Phone:585-385-4867
Mailing Address - Fax:585-385-4914
Practice Address - Street 1:151 SULLYS TRL
Practice Address - Street 2:PROGRESSIVE IMPLANTOLOGY & PERIODONTICS
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4562
Practice Address - Country:US
Practice Address - Phone:585-385-4867
Practice Address - Fax:585-385-4914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0511081223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty