Provider Demographics
NPI:1821596115
Name:GODEL & ASSOCIATES II PLLC
Entity type:Organization
Organization Name:GODEL & ASSOCIATES II PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GODEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-604-5002
Mailing Address - Street 1:6655 E WILKINSON BLVD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-4706
Mailing Address - Country:US
Mailing Address - Phone:704-461-1116
Mailing Address - Fax:
Practice Address - Street 1:5232 ALBEMARLE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-2659
Practice Address - Country:US
Practice Address - Phone:704-689-1412
Practice Address - Fax:704-626-3096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC75641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty