Provider Demographics
NPI:1033989637
Name:GODEL & ASSOCIATES II PLLC
Entity Type:Organization
Organization Name:GODEL & ASSOCIATES II PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATION MANGER
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 1:2320 CONCORD LAKE RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2814
Practice Address - Country:US
Practice Address - Phone:704-755-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHARLOTTE FAMILY DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty