Provider Demographics
NPI:1508952391
Name:GODING, NORMAN R (DDS)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:R
Last Name:GODING
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 1:1966 W. 15TH ST.
Mailing Address - Street 2:SUITE #1
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-3565
Mailing Address - Country:US
Mailing Address - Phone:970-669-5700
Mailing Address - Fax:970-669-5726
Practice Address - Street 1:1966 W 15TH ST
Practice Address - Street 2:SUITE #1
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-3599
Practice Address - Country:US
Practice Address - Phone:970-669-5700
Practice Address - Fax:970-669-5726
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice