Provider Demographics
NPI:1821811431
Name:ANDREW C GOOCH DMD PLLC
Entity type:Organization
Organization Name:ANDREW C GOOCH DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:GOOCH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:352-562-2616
Mailing Address - Street 1:1310 WINDERMERE RD
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5598
Mailing Address - Country:US
Mailing Address - Phone:407-566-4646
Mailing Address - Fax:
Practice Address - Street 1:1310 WINDERMERE RD
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5598
Practice Address - Country:US
Practice Address - Phone:407-566-4646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-02
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty