MEDICARE: DR. NATALIE ELIZABETH GOODMAN D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	21264	TX

General Provider Information

NPI Number	:	1548474364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATALIE ELIZABETH GOODMAN D.D.S

Provider Business Mailing Address
First Line	:	2412 OLD NORTH RD STE 100A
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76209-1524
Country	:	US
Telephone Number	:	940-382-9960
Fax Number	:	940-387-7014

Provider Business Practice Location Address
First Line	:	2412 OLD NORTH RD STE 100A
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76209-1524
Country	:	US
Telephone Number	:	940-382-9960
Fax Number	:	940-387-7014

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	02/21/2023

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