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General NPI Number Information
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NPI Number | 1598973406
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Entity Type | Organization
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Legal Business Name | LAWRENCE E. GOODMAN, D.M.D., P.C.
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 450 N MAIN ST
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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 | 781-784-3363
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Provider Business Mailing Address
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Address Line | PO BOX 67
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City | SHARON
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State | MA
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Zip | 02067-0067
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Country | US
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Telephone | 781-784-3330
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Fax | 781-784-3363
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAWRENCE GOODMAN
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Credential | DMD
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Telephone | 781-784-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 17672
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License Number State | MA
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