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General NPI Number Information
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NPI Number | 1023210671
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Entity Type | Individual
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Provider Name | MARWIN E. GOFF DDS
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Gender | Male
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 64 COPPER CANYON LOOP
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City | CAMP VERDE
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State | AZ
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Zip | 86322-0257
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Country | US
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Telephone | 515-360-0778
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Fax |
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Provider Business Mailing Address
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Address Line | 3906 WOLCOTT AVE
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City | DES MOINES
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State | IA
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Zip | 50321-1868
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Country | US
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Telephone | 515-360-0778
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 07053
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D011602
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License Number State | AZ
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