Provider Demographics
NPI:1376530535
Name:GOULD, STUART S (DMD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:S
Last Name:GOULD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:116 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2723
Mailing Address - Country:US
Mailing Address - Phone:978-745-7363
Mailing Address - Fax:617-566-0948
Practice Address - Street 1:116 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2723
Practice Address - Country:US
Practice Address - Phone:978-745-7363
Practice Address - Fax:617-566-0948
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA104341223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry