Provider Demographics
NPI:1588023576
Name:L. CLIFFORD GOFF DDS
Entity Type:Organization
Organization Name:L. CLIFFORD GOFF DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:CLIFFORD
Authorized Official - Last Name:GOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-621-7782
Mailing Address - Street 1:2720 CHRISTENSEN AVE
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-0522
Mailing Address - Country:US
Mailing Address - Phone:801-621-7782
Mailing Address - Fax:
Practice Address - Street 1:2720 CHRISTENSEN AVE
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-0522
Practice Address - Country:US
Practice Address - Phone:801-621-7782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty