Provider Demographics
NPI:1568599074
Name:GOOBES, IFTACH (JEFF ) (DENTURIST)
Entity Type:Individual
Prefix:MR
First Name:IFTACH (JEFF )
Middle Name:
Last Name:GOOBES
Suffix:
Gender:M
Credentials:DENTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 140TH AVE NE # 100B
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2974
Mailing Address - Country:US
Mailing Address - Phone:425-746-6990
Mailing Address - Fax:425-747-9856
Practice Address - Street 1:1130 140TH AVE NE # 100B
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2974
Practice Address - Country:US
Practice Address - Phone:425-746-6990
Practice Address - Fax:425-747-9856
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADN0189122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist