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General NPI Number Information
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NPI Number | 1013603216
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Entity Type | Organization
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Legal Business Name | GREGORY G. GOGGANS, D.M.D. ARKANSAS, P.A.
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Dates
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Enumeration Date | 04/12/2023
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 2890 W HUNTSVILLE AVE
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City | SPRINGDALE
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State | AR
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Zip | 72762-7735
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Country | US
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Telephone | 479-751-1103
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Fax |
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Provider Business Mailing Address
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Address Line | 5400 LBJ FWY STE 800
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City | DALLAS
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State | TX
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Zip | 75240-1058
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORY GOGGANS
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Credential |
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Telephone | 719-569-5715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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