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General NPI Number Information
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NPI Number | 1295171148
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Entity Type | Individual
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Provider Name | KATHERINE LYNN GOODWIN D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 05/20/2013
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Last Update Date | 05/20/2013
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Provider Practice Location Address
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Address Line | 4106 6TH AVE
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City | KEARNEY
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State | NE
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Zip | 68845-3395
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Country | US
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Telephone | 308-237-3479
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Fax | 308-236-9642
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Provider Business Mailing Address
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Address Line | 4106 6TH AVE
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City | KEARNEY
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State | NE
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Zip | 68845-3395
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Country | US
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Telephone | 308-237-3479
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Fax | 308-236-9642
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7084
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License Number State | NE
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