Provider Demographics
NPI:1467811356
Name:GOYAL, SAACHI (DDS)
Entity Type:Individual
Prefix:
First Name:SAACHI
Middle Name:
Last Name:GOYAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ROCKCLIFF LANDING NW
Mailing Address - Street 2:
Mailing Address - City:CALGARY
Mailing Address - State:ALBERTA
Mailing Address - Zip Code:T3G5Z6
Mailing Address - Country:CA
Mailing Address - Phone:403-604-2656
Mailing Address - Fax:
Practice Address - Street 1:3756 US HIGHWAY 98 N
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-3809
Practice Address - Country:US
Practice Address - Phone:863-286-0380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21729122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist