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General NPI Number Information
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NPI Number | 1437368800
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Entity Type | Organization
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Legal Business Name | DENTURES PLUS, PLLC
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3111 SOUTHWEST BLVD
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City | SAN ANGELO
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State | TX
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Zip | 76904-5742
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Country | US
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Telephone | 325-224-4333
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Fax |
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Provider Business Mailing Address
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Address Line | 3111 SOUTHWEST BLVD
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City | SAN ANGELO
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State | TX
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Zip | 76904-5742
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Country | US
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Telephone | 325-224-4333
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | DR. JOHN G. GOODMAN II
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Credential | DDS
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Telephone | 325-224-2804
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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 | 11749
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License Number State | TX
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