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General NPI Number Information
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NPI Number | 1235844739
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Entity Type | Organization
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Legal Business Name | ELIZABETH BLAIR GOODALL DDS PLLC
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Dates
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Enumeration Date | 01/18/2023
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 2155 UNIVERSITY DR STE 120
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City | FRISCO
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State | TX
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Zip | 75033-1224
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Country | US
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Telephone | 469-598-1070
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Fax |
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Provider Business Mailing Address
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Address Line | 2809 MOUNTAIN LAUREL LN
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City | PLANO
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State | TX
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Zip | 75093-4071
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Country | US
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Telephone | 304-490-9432
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST/OWNER
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Name | DR. ELIZABETH GOODALL
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Credential | DDS
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Telephone | 304-490-9432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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