Provider Demographics
NPI:1184063737
Name:GOFF, MONICA L (DDS)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:L
Last Name:GOFF
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15816 BREEDLOVE PL
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-6334
Mailing Address - Country:US
Mailing Address - Phone:214-364-4431
Mailing Address - Fax:
Practice Address - Street 1:2601 BOLTON BOONE DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2011
Practice Address - Country:US
Practice Address - Phone:972-296-6655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28930122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist