Individual
DR. MICHAEL TIMOTHY GOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7601 LEWINSVILLE RD, SUITE 203, MCLEAN, VA 22102-2814
(703) 388-2805
(703) 388-2806
Mailing address
PO BOX 645205, PITTSBURGH, PA 15264-5205
(866) 756-3200
(479) 725-2395
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401411538
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
3585
WV
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
0401411538
VA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
3585
WV
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
0401411538
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9200594
—
VA
Enumeration date
04/02/2007
Last updated
12/12/2016
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