Provider Demographics
NPI:1306944624
Name:GOULD, ANDREW DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DAVID
Last Name:GOULD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-1127
Mailing Address - Country:US
Mailing Address - Phone:717-774-7700
Mailing Address - Fax:717-774-7747
Practice Address - Street 1:1902 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NEW CUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17070-1127
Practice Address - Country:US
Practice Address - Phone:717-774-7700
Practice Address - Fax:717-774-7747
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029714L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADS029714LOtherWWW.ANDREWDGOULDDMD.COM