DR. Thomas Leland Gough, D.D.S.

NPI #1871838227 in Mchenry, Illinois

Provider Information

NPI Number: 1871838227
Entity Type: Individual
Name: DR. Thomas Leland Gough, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Dec 11, 2012
Last Updated: Dec 11, 2012

Practice Location

Address: 1315 N RIVERSIDE DR
City: Mchenry
State: Illinois
ZIP Code: 60050-4509
Phone: (815) 385-1360

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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