NPI | 1265090443 |
---|---|
Doing Business As | GOODMAN ROAD DENTAL PLLC |
Entity Type | Organization |
Authorized Contact | MAX S. BREAZEAL Owner 901-861-0031 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Enumeration Date | 2019-06-03 |
Last Update Date | 2019-06-03 |