Provider Demographics
NPI:1033977327
Name:GODEL & ASSOCIATES III PLLC
Entity Type:Organization
Organization Name:GODEL & ASSOCIATES III PLLC
Other - Org Name:RALEIGH FAMILY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATION MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-689-1412
Mailing Address - Street 1:6655 E WILKINSON BLVD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-4706
Mailing Address - Country:US
Mailing Address - Phone:704-689-1412
Mailing Address - Fax:
Practice Address - Street 1:1617 RONALD DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6224
Practice Address - Country:US
Practice Address - Phone:919-899-8063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHAPEL HILL FAMILY DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-11
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty