Organization Name: | GOULD DENTAL CORPORATION |
NPI Number: | 1134503535 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOEL DAVID GOULD (PRESIDENT) |
Mailing Address: | 1200 Rosecrans Ave 107 Manhattan Beach |
State: | CA US |
Postal Code: | 902662462 |
Phone Number: | 3106400967 |
Fax Number: | 3106079292 |
NPI Enumeration Date: | 07/15/2015 |
NPI Last Update Date: | 07/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 302R00000X |
License Number: | 48276 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Health Maintenance Organization |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |