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General NPI Number Information
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NPI Number | 1750826319
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Entity Type | Organization
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Legal Business Name | GODEL & ASSOCIATES PLLC
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Dates
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Enumeration Date | 01/05/2017
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Last Update Date | 01/05/2017
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Provider Practice Location Address
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Address Line | 145 COLUMBINE DR
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City | WINSTON SALEM
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State | NC
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Zip | 27106-3106
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Country | US
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Telephone | 704-689-1412
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Fax |
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Provider Business Mailing Address
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Address Line | 145 COLUMBINE DR
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City | WINSTON SALEM
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State | NC
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Zip | 27106-3106
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Country | US
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Telephone | 704-689-1412
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ERICA B BEACH
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Credential |
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Telephone | 704-689-1412
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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 |
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License Number State | NC
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