Provider Demographics
NPI:1497930804
Name:GOEL, ANSHU (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANSHU
Middle Name:
Last Name:GOEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1912
Mailing Address - Country:US
Mailing Address - Phone:978-332-0000
Mailing Address - Fax:
Practice Address - Street 1:109 MIDDLESEX ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-2112
Practice Address - Country:US
Practice Address - Phone:978-441-1999
Practice Address - Fax:978-441-0711
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22048122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist