Provider Demographics
NPI:1659031912
Name:GOGGANS ASSOCIATES OF NORTH CAROLINA PC
Entity Type:Organization
Organization Name:GOGGANS ASSOCIATES OF NORTH CAROLINA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:G
Authorized Official - Last Name:GOGGANS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:817-988-3476
Mailing Address - Street 1:5400 LBJ FWY STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-1058
Mailing Address - Country:US
Mailing Address - Phone:817-988-3476
Mailing Address - Fax:
Practice Address - Street 1:6331 CARMEL RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-8286
Practice Address - Country:US
Practice Address - Phone:704-542-9995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty