Provider Demographics
NPI:1093578320
Name:JAMES T. GOOTS D.D.S., P.L.L.C.
Entity Type:Organization
Organization Name:JAMES T. GOOTS D.D.S., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:THADDEUS
Authorized Official - Last Name:GOOTS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-726-1461
Mailing Address - Street 1:3002 BRIDGES ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-3330
Mailing Address - Country:US
Mailing Address - Phone:252-726-1461
Mailing Address - Fax:
Practice Address - Street 1:3002 BRIDGES ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-3330
Practice Address - Country:US
Practice Address - Phone:252-726-1461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental