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NPI 1598677593

NPI 1598677593 : GODDARD FAMILY DENTAL : GODDARD, KS

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General NPI Number Information
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    NPI Number           |    1598677593
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    Entity Type          |    Organization 
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    Legal Business Name  |    GODDARD FAMILY DENTAL 
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Dates
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    Enumeration Date     |    09/22/2026
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    Last Update Date     |    09/22/2026
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Provider Practice Location Address
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    Address Line         |    19931 W KELLOGG DR UNIT C 
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    City                 |    GODDARD
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    State                |    KS
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    Zip                  |    67052-8864
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    Country              |    US
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    Telephone            |    316-550-6020
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    Fax                  |    316-550-6039
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Provider Business Mailing Address
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    Address Line         |    19931 W KELLOGG DR UNIT C 
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    City                 |    GODDARD
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    State                |    KS
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    Zip                  |    67052-8864
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    Country              |    US
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    Telephone            |    316-550-6020
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    Fax                  |    316-550-6039
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Authorized Official
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    Title or Position    |    DENTIST
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    Name                 |    DR. ERIC  MCANALLY 
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    Credential           |    DMD
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    Telephone            |    316-550-6020
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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       |    
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    License Number State |    
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