Individual
KELLY GOECKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1505 SW CARY PKWY, CARY, NC 27511-6219
(919) 249-4900
Mailing address
1692 MILLER AVE, ANN ARBOR, MI 48103-2548
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9296
NC
Other
Enumeration date
02/28/2015
Last updated
02/28/2015
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