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General NPI Number Information
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NPI Number | 1861661555
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Entity Type | Individual
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Provider Name | NANCY LOUISE GOEBEL D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 3932 WILSHIRE BLVD 300
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City | LOS ANGELES
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State | CA
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Zip | 90010-3307
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Country | US
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Telephone | 213-386-7846
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Fax |
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Provider Business Mailing Address
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Address Line | 4637 LINDLEY AVE
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City | TARZANA
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State | CA
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Zip | 91356-4612
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Country | US
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Telephone | 818-344-5304
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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 | 30527
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License Number State | CA
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