Provider Demographics
NPI:1578789384
Name:GO, NANCY (DMD)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:GO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 SKYWAY
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-7129
Mailing Address - Country:US
Mailing Address - Phone:530-781-1271
Mailing Address - Fax:530-345-9382
Practice Address - Street 1:1016 SKYWAY
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-7129
Practice Address - Country:US
Practice Address - Phone:530-781-1271
Practice Address - Fax:530-345-9382
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice