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1902992043
KEN G GOODWIN
BOONEVILLE, MS
NPI
1902992043
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: MS 1971-82)
Enumeration Date
2006-10-05
Last Update Date
2007-07-08
Business Address
Dr. KEN G GOODWIN DMD, PA
403 NORTH THIRD STREET
BOONEVILLE, MS 38829
Phone number: 662-728-8171
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Mailing Address
Dr. KEN G GOODWIN DMD, PA
PO BOX 877
BOONEVILLE, MS 38829-0877
Phone number: 662-728-8171
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