Provider Demographics
NPI:1609818970
Name:GOFF, NATHAN E (DMD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:E
Last Name:GOFF
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 PORTLAND FARMS RD
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8305
Mailing Address - Country:US
Mailing Address - Phone:207-883-0045
Mailing Address - Fax:207-883-4845
Practice Address - Street 1:7 PORTLAND FARMS RD
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-8305
Practice Address - Country:US
Practice Address - Phone:207-883-0045
Practice Address - Fax:207-883-4845
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3408122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist