Provider Demographics
NPI:1609027507
Name:DONALD C. GOECKEL, D.D.S.,P.C.
Entity Type:Organization
Organization Name:DONALD C. GOECKEL, D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:GOECKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-686-6110
Mailing Address - Street 1:3433 E MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-2825
Mailing Address - Country:US
Mailing Address - Phone:989-686-6110
Mailing Address - Fax:989-686-6170
Practice Address - Street 1:3433 E MIDLAND RD
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2825
Practice Address - Country:US
Practice Address - Phone:989-686-6110
Practice Address - Fax:989-686-6170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI101271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty