Organization
RONALD F GODAT DDS MS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD FULTON GODAT DDS MS (PRESIDENT)
(423) 239-3993
Entity
Organization
Contact information
Practice address
210 LOCKPORT CIRCLE, KINGSPORT, TN 37664
(423) 239-3993
(423) 239-9499
Mailing address
210 LOCKPORT CIRCLE, KINGSPORT, TN 37664
(423) 239-3993
(423) 239-9499
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DS2061
TN
Other
Enumeration date
09/21/2006
Last updated
08/22/2020
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