| Organization Name: | GOODYEAR ENDODONTICS, P.C. |
| NPI Number: | 1003070392 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT STEPHEN KANE (PRESIDENT) |
| Mailing Address: | 1646 N Litchfield Rd Suite 260 Goodyear |
| State: | AZ US |
| Postal Code: | 853951203 |
| Phone Number: | 6235357899 |
| Fax Number: | 6235357821 |
| NPI Enumeration Date: | 07/15/2008 |
| NPI Last Update Date: | 07/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 3266 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |