Individual
DR. MATTHEW P GODFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1598 DELPHIC WAY, POCATELLO, ID 83201-2232
(208) 637-1300
(208) 637-0798
Mailing address
1598 DELPHIC WAY, POCATELLO, ID 83201-2232
(208) 637-1300
(208) 637-0798
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4490
ID
Other
Enumeration date
06/19/2013
Last updated
08/17/2016
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