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General NPI Number Information
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NPI Number | 1164160966
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Entity Type | Individual
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Provider Name | DAVID GOODMAN DMD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2022
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 450 N MAIN ST STE 4
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City | SHARON
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State | MA
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Zip | 02067-1172
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Country | US
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Telephone | 781-784-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 450 N MAIN ST STE 4
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City | SHARON
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State | MA
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Zip | 02067-1172
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS043602
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN1859710
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License Number State | MA
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