Goodman Road Dental Pllc

NPI #1265090443 in Olive Branch, Mississippi

Provider Information

NPI Number: 1265090443
Entity Type: Organization
Organization Name: Goodman Road Dental Pllc
Primary Specialty: Dentist
Enumeration Date: Jun 3, 2019
Last Updated: Jun 3, 2019

Practice Location

Address: 7271 GOODMAN RD
City: Olive Branch
State: Mississippi
ZIP Code: 38654-1906
Phone: (662) 895-4737

Authorized Official

Name: DR. MAX S. BREAZEAL, DDS
Title: OWNER
Phone: (901) 861-0031

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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