Organization
ALAN R GOULD DDS MS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN R GOULD DDS MS (ORAL & MAXILLOFACIAL PATHOLOGIST)
(502) 241-7116
Entity
Organization
Contact information
Practice address
5805 W HIGHWAY 22, CRESTWOOD, KY 40014-7244
(502) 241-7116
(502) 241-2339
Mailing address
1169 EASTERN PKWY, SUITE G71, LOUISVILLE, KY 40217-1417
(502) 456-6217
(502) 456-4440
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
12010715A
IN
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
4925
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200022760B
—
IN
01
—
DC2238
RAILROAD MEDICARE
—
Enumeration date
08/05/2006
Last updated
01/13/2017
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