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General NPI Number Information
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NPI Number | 1124110200
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Entity Type | Organization
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Legal Business Name | GODLEY FAMILY DENTISTY , PA
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 925 HIGH POINT DR
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City | NAPLES
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State | FL
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Zip | 34103-3879
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Country | US
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Telephone | 239-262-1535
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Fax | 239-261-0730
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Provider Business Mailing Address
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Address Line | 925 HIGH POINT DR
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City | NAPLES
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State | FL
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Zip | 34103-3879
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Country | US
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Telephone | 239-262-1535
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Fax | 239-261-0730
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LANCE WILLIAM GODLEY
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Credential | D. M. D.
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Telephone | 239-262-1535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN14581
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License Number State | FL
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