Provider Demographics
NPI:1427348218
Name:GOBER PRACTICE ACQUISITIONS, PLLC
Entity type:Organization
Organization Name:GOBER PRACTICE ACQUISITIONS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RALSTON
Authorized Official - Last Name:GOBER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-980-0298
Mailing Address - Street 1:1440 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-4496
Mailing Address - Country:US
Mailing Address - Phone:972-579-5000
Mailing Address - Fax:972-579-5001
Practice Address - Street 1:1440 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-4496
Practice Address - Country:US
Practice Address - Phone:972-579-5000
Practice Address - Fax:972-579-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16709122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty