Provider Demographics
NPI:1518087170
Name:GODBY, DENNIS GERARD (ND)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:GERARD
Last Name:GODBY
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 AMADOR AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-3012
Mailing Address - Country:US
Mailing Address - Phone:530-759-1226
Mailing Address - Fax:
Practice Address - Street 1:1507 21ST ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-5220
Practice Address - Country:US
Practice Address - Phone:916-446-2591
Practice Address - Fax:916-446-2592
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath