NPI | 1174798045 |
---|---|
Former Legal Business Name | MARK W. GOODMAN, D.D.S., PC |
Entity Type | Organization |
Authorized Contact | JEANNA GOODMAN Office Manager 580-482-5424 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2008-04-23 |
Last Update Date | 2011-01-24 |