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General NPI Number Information
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NPI Number | 1235913666
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER GOODELL, DMD, PLLC
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Dates
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Enumeration Date | 08/24/2023
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 107 HAMMOND LN STE 1
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City | PLATTSBURGH
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State | NY
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Zip | 12901-2021
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Country | US
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Telephone | 518-565-0828
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Fax |
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Provider Business Mailing Address
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Address Line | 107 HAMMOND LN STE 1
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City | PLATTSBURGH
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State | NY
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Zip | 12901-2021
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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 | PRACTICE OWNER
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Name | DR. CHRISTOPHER GOODELL
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Credential | DMD
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Telephone | 518-565-0828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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