DR. Daniel Tim Goodman JR., D.D.S

NPI #1699835603 in Bolivar, Missouri

Provider Information

NPI Number: 1699835603
Entity Type: Individual
Name: DR. Daniel Tim Goodman JR., D.D.S
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: D.D.S
Enumeration Date: Dec 11, 2006
Last Updated: Jul 8, 2007

Practice Location

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

Specialties & Taxonomy Codes

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

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