| NPI | 1174072409 |
|---|---|
| Doing Business As | GOODMAN DENTAL |
| Entity Type | Organization |
| Authorized Contact | DEBBIE K SHIELDS Business Office 662-840-1535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 233887) |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2016-09-28 |