Provider Demographics
NPI:1881682755
Name:GOETZE, ROBERT JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOHN
Last Name:GOETZE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 E ROMIE LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3158
Mailing Address - Country:US
Mailing Address - Phone:831-443-1151
Mailing Address - Fax:831-443-8334
Practice Address - Street 1:130 E ROMIE LN
Practice Address - Street 2:SUITE A
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3158
Practice Address - Country:US
Practice Address - Phone:831-443-1151
Practice Address - Fax:831-443-8334
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA228031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice