Provider Demographics
NPI:1871896886
Name:GOOD, PHOEBE (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:PHOEBE
Middle Name:
Last Name:GOOD
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 24TH ST
Mailing Address - Street 2:APT 17
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-3741
Mailing Address - Country:US
Mailing Address - Phone:415-902-1787
Mailing Address - Fax:
Practice Address - Street 1:260 STOCKTON ST
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-5305
Practice Address - Country:US
Practice Address - Phone:415-399-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-13
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA561781223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics