Provider Demographics
NPI:1124244900
Name:GOPAL, HEMA (DMD)
Entity type:Individual
Prefix:DR
First Name:HEMA
Middle Name:
Last Name:GOPAL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 FARNSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-1708
Mailing Address - Country:US
Mailing Address - Phone:609-298-1124
Mailing Address - Fax:
Practice Address - Street 1:321 FARNSWORTH AVE
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-1708
Practice Address - Country:US
Practice Address - Phone:609-298-1124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ208031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice