NPI | 1003332867 |
---|---|
Other Name | B. CASEY GOOCH |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 2021028134) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 33285) |
Enumeration Date | 2017-08-14 |
Last Update Date | 2024-05-07 |