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General NPI Number Information
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NPI Number | 1770470379
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Entity Type | Organization
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Legal Business Name | GODOY DDS INC
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 4434 UNIVERSITY PKWY STE G
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-4681
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Country | US
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Telephone | 909-887-1533
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Fax |
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Provider Business Mailing Address
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Address Line | 4434 UNIVERSITY PKWY STE G
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City | SAN BERNARDINO
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State | CA
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Zip | 92407-4681
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Country | US
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Telephone | 725-500-7968
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST/PRESIDENT
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Name | DR. ANDREW GODOY
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Credential | DDS
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Telephone | 725-500-7968
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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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