Individual
DR. HAROLD LEE GOFORTH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1321 STADIUM DR, BLUEFIELD, WV 24701-3318
(304) 327-7135
Mailing address
PO BOX 607, BLUEFIELD, WV 24701-0607
(304) 327-7135
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2416
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136312000
—
WV
Enumeration date
09/20/2006
Last updated
04/16/2015
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