Provider Demographics
NPI:1487884011
Name:GOYAL, RIDHIMA (DMD)
Entity type:Individual
Prefix:MRS
First Name:RIDHIMA
Middle Name:
Last Name:GOYAL
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 1:57 COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-3097
Mailing Address - Country:US
Mailing Address - Phone:860-496-1200
Mailing Address - Fax:877-387-9440
Practice Address - Street 1:57 COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-3097
Practice Address - Country:US
Practice Address - Phone:860-496-1200
Practice Address - Fax:877-387-9440
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT101541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice