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General NPI Number Information
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NPI Number | 1194883918
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Entity Type | Individual
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Provider Name | JEFFREY HAROLD GODEL .D.DS.
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 3223 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5007
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Country | US
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Telephone | 157-074-0022
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Fax |
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Provider Business Mailing Address
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Address Line | 26 WESTMINSTER DR
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City | VOORHEES
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State | NJ
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Zip | 08043-3703
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Country | US
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Telephone | 609-876-6542
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | NJ DI1722
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS021914L
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License Number State | PA
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