Provider Demographics
NPI:1780908517
Name:RAJ J GOHEL DMD P.C.
Entity type:Organization
Organization Name:RAJ J GOHEL DMD P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJENDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOHEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-685-7115
Mailing Address - Street 1:100 MILK ST # 200
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-4600
Mailing Address - Country:US
Mailing Address - Phone:978-685-7115
Mailing Address - Fax:
Practice Address - Street 1:100 MILK ST # 200
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-4600
Practice Address - Country:US
Practice Address - Phone:978-685-7115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA19865122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty