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General NPI Number Information
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NPI Number | 1891215497
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Entity Type | Individual
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Provider Name | ELIZABETH ANNE GOEBEL DMD
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Gender | Female
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Dates
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Enumeration Date | 06/23/2017
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 5823 WOOSTER PIKE
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City | CINCINNATI
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State | OH
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Zip | 45227-4505
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Country | US
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Telephone | 513-271-0821
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Fax |
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Provider Business Mailing Address
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Address Line | 620 E 10TH ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-1810
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 9944
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 10556
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.025271
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License Number State | OH
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