Provider Demographics
NPI:1841498631
Name:GOVE, RAYMOND JOHN (DDS)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:JOHN
Last Name:GOVE
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 1:8965 SOMMERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-4731
Mailing Address - Country:US
Mailing Address - Phone:317-502-9797
Mailing Address - Fax:
Practice Address - Street 1:12720 MEETING HOUSE RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-7334
Practice Address - Country:US
Practice Address - Phone:317-571-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011015A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice