Basic Information
Provider Information
NPI: 1184681124
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GOHO
FirstName: CURTIS
MiddleName: DONALD
NamePrefix: DR.
NameSuffix: JR.
Credential: D.D.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: US ARMY DENTAL ACTIVITY BAVARIA
Address2: UNIT 28038
City: APO
State: AE
PostalCode: 09112
CountryCode: US
TelephoneNumber: 011499662834738
FaxNumber:  
Practice Location
Address1: US ARMY DENTAL ACTIVITY BAVARIA
Address2: UNIT 28038
City: APO
State: AE
PostalCode: 09112
CountryCode: US
TelephoneNumber: 011499662834738
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/26/2006
LastUpdateDate: 07/29/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X0401008300VAY Dental ProvidersDentist 

No ID Information.


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