Individual provider · NPI-1
William Colton Godfrey, DHAT
Dental Therapist · Anchorage, AK
NPI number1902653264
StatusActive
Last updated in NPPESMay 3, 2024
Details
- NPI
- 1902653264
- Entity type
- Individual (NPI-1)
- Name
- William Colton Godfrey
- Credential
- DHAT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 3, 2024
- Certification date
- May 3, 2024
- Last updated
- May 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 125J00000X | Dental Therapist | 24-181-DHAT | AK | Yes |
Practice location
4441 Diplomacy DrAnchorage, AK 99508-5910
Phone 907-729-2000
Mailing address
7033 E Tudor RdAnchorage, AK 99507-1262
Phone 907-729-8961 · Fax 907-729-5180
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