Provider Demographics
NPI:1073746319
Name:GOINGS ORTHODONTICS
Entity Type:Organization
Organization Name:GOINGS ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:GOINGS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PC
Authorized Official - Phone:970-377-1888
Mailing Address - Street 1:4733 S TIMBERLINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3023
Mailing Address - Country:US
Mailing Address - Phone:970-377-1888
Mailing Address - Fax:970-377-1889
Practice Address - Street 1:4733 S TIMBERLINE RD STE 101
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3023
Practice Address - Country:US
Practice Address - Phone:970-377-1888
Practice Address - Fax:970-377-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty