| Dustin V. Goodwin D.d.s. P.c | |
|
75 E 1400 S Garland UT 84312-9316 | |
| (435) 257-7016 | |
| (435) 257-4590 |
| Full Name | Dustin V. Goodwin D.d.s. P.c |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 75 E 1400 S, Garland, Utah |
| Authorized Official Name and Position | Dustin Vinal Goodwin (PRESIDENT) |
| Authorized Official Contact | 4352577016 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dustin V. Goodwin D.d.s. P.c 75 E 1400 S Po Box 99 Garland UT 84312-9316 Ph: (435) 257-7016 | Dustin V. Goodwin D.d.s. P.c 75 E 1400 S Garland UT 84312-9316 Ph: (435) 257-7016 |
| NPI Number | 1679679435 |
|---|---|
| Provider Enumeration Date | 09/16/2006 |
| Last Update Date | 07/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679679435 | NPI | - | NPPES |
| 806174600 | Medicaid | ID | |
| 1319810 | Other | UNITED CONCORDIA/TRICARE | |
| 6H429 | Other | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D-3532 (Idaho) | Primary |