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General NPI Number Information
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NPI Number | 1154320604
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Entity Type | Individual
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Provider Name | MOISES GOTBETER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 925 SOUTH MAIN ST. #8
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City | ANTHONY
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State | TX
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Zip | 79821
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Country | US
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Telephone | 915-886-2555
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Fax | 915-886-2555
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Provider Business Mailing Address
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Address Line | PO BOX 13452
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City | EL PASO
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State | TX
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Zip | 79913-3452
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Country | US
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Telephone | 915-886-2555
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Fax | 915-886-4273
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18226
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License Number State | TX
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