Daniel T. Goodman DDS LLC

NPI #1124284658 in Bolivar, Missouri

Provider Information

NPI Number: 1124284658
Entity Type: Organization
Organization Name: Daniel T. Goodman DDS LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 4, 2008
Last Updated: Aug 4, 2008

Practice Location

Address: 305 E BROADWAY ST
City: Bolivar
State: Missouri
ZIP Code: 65613-1625
Phone: (417) 326-4113

Authorized Official

Name: DR. DANIEL T GOODMAN, DDS
Title: OWNER/DENTIST
Phone: (417) 326-4113

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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