Provider Demographics
NPI:1407180979
Name:GOLI, ARASH
Entity Type:Individual
Prefix:
First Name:ARASH
Middle Name:
Last Name:GOLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 STATE RD
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2567
Mailing Address - Country:US
Mailing Address - Phone:978-777-3744
Mailing Address - Fax:978-777-1544
Practice Address - Street 1:6 STATE RD
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2567
Practice Address - Country:US
Practice Address - Phone:978-777-3744
Practice Address - Fax:978-777-1544
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18552451223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry