| Daniel T. Goodman Dds Llc | |
|
305 E Broadway St Bolivar MO 65613-1625 | |
| (417) 326-4113 | |
| (417) 326-4115 |
| Full Name | Daniel T. Goodman Dds Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 305 E Broadway St, Bolivar, Missouri |
| Authorized Official Name and Position | Daniel T Goodman (OWNER/DENTIST) |
| Authorized Official Contact | 4173264113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel T. Goodman Dds Llc 305 E Broadway St Bolivar MO 65613-1625 Ph: (417) 326-4113 | Daniel T. Goodman Dds Llc 305 E Broadway St Bolivar MO 65613-1625 Ph: (417) 326-4113 |
| NPI Number | 1124284658 |
|---|---|
| Provider Enumeration Date | 08/04/2008 |
| Last Update Date | 08/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124284658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2005015020 (Missouri) | Primary |
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