Provider Demographics
NPI:1619561206
Name:STEVEN GOACHER DDS PLLC
Entity Type:Organization
Organization Name:STEVEN GOACHER DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOACHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-994-7645
Mailing Address - Street 1:1171 HIGHWAY 62 412
Mailing Address - Street 2:
Mailing Address - City:ASH FLAT
Mailing Address - State:AR
Mailing Address - Zip Code:72513-9612
Mailing Address - Country:US
Mailing Address - Phone:870-994-7645
Mailing Address - Fax:870-994-3566
Practice Address - Street 1:1171 HIGHWAY 62 412
Practice Address - Street 2:
Practice Address - City:ASH FLAT
Practice Address - State:AR
Practice Address - Zip Code:72513-9612
Practice Address - Country:US
Practice Address - Phone:870-994-7645
Practice Address - Fax:870-994-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental