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Individual
GODYS SOSA
Active
Individual
GODYS SOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ND
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2435
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TRIPLE S
TRIPLES
PR
Enumeration date
11/11/2005
Last updated
05/08/2008
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