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General NPI Number Information
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NPI Number | 1750569117
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Entity Type | Organization
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Legal Business Name | ERNEST J. GOODSON, DDS
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 950 SOUTH MCPHERSON CHURCH RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28303
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Country | US
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Telephone | 910-483-2633
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Fax | 910-485-2841
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Provider Business Mailing Address
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Address Line | 950 SOUTH MCPHERSON CHURCH RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28303
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Country | US
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Telephone | 910-483-2633
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Fax | 910-485-2841
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. ERNEST JEROME GOODSON
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Credential | DDS
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Telephone | 910-483-2633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 104771
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License Number State | NC
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