Provider Demographics
NPI:1811602964
Name:KRISTEN M. GOBLE, DMD, PLLC
Entity type:Organization
Organization Name:KRISTEN M. GOBLE, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:734-649-6958
Mailing Address - Street 1:PO BOX 1299
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-1299
Mailing Address - Country:US
Mailing Address - Phone:828-682-1560
Mailing Address - Fax:
Practice Address - Street 1:501 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-2834
Practice Address - Country:US
Practice Address - Phone:828-682-1560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental