Provider Demographics
NPI:1942468848
Name:PATEL, GAURI GOYAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:GAURI
Middle Name:GOYAL
Last Name:PATEL
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 1:400 E SILVER SPRING DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-5224
Mailing Address - Country:US
Mailing Address - Phone:414-332-6010
Mailing Address - Fax:414-322-1850
Practice Address - Street 1:400 E SILVER SPRING DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53217-5224
Practice Address - Country:US
Practice Address - Phone:414-332-6010
Practice Address - Fax:414-322-1850
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019027322122300000X
WI6304-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist