Provider Demographics
NPI:1770709495
Name:GOEHRING, DENNIS P (DDS)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:P
Last Name:GOEHRING
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 1:3421 W WILLIAM CANNON DR
Mailing Address - Street 2:SUITE 141
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5000
Mailing Address - Country:US
Mailing Address - Phone:512-892-8822
Mailing Address - Fax:512-899-1290
Practice Address - Street 1:3421 W WILLIAM CANNON DR
Practice Address - Street 2:SUITE 141
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5000
Practice Address - Country:US
Practice Address - Phone:512-892-8822
Practice Address - Fax:512-899-1290
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11808101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice