Provider Demographics
NPI:1023210671
Name:GOFF, MARWIN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARWIN
Middle Name:E
Last Name:GOFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 WOLCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50321-1868
Mailing Address - Country:US
Mailing Address - Phone:515-360-0778
Mailing Address - Fax:
Practice Address - Street 1:64 COPPER CANYON LOOP
Practice Address - Street 2:
Practice Address - City:CAMP VERDE
Practice Address - State:AZ
Practice Address - Zip Code:86322-0257
Practice Address - Country:US
Practice Address - Phone:515-360-0778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA07053122300000X
AZD011602122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist