Individual
DR. JEFFREY PAUL GODBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
700 SHERIDAN LAKE RD, RAPID CITY, SD 57702-2407
(605) 341-3068
(605) 341-5757
Mailing address
700 SHERIDAN LAKE RD, RAPID CITY, SD 57702-2407
(605) 341-3068
(605) 341-5757
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D0408
SD
1223G0001X
General Practice Dentistry
WY 946
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100249748-00
—
NE
05
—
120229100
—
WY
05
—
D0408
—
SD
Enumeration date
11/09/2006
Last updated
07/14/2014
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