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Individual
RONALD SCOTT GOODMAN
Active
Individual
RONALD SCOTT GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15034
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2613950
—
MI
01
—
J800813
BLUE CROSS ID
MI
Enumeration date
01/09/2006
Last updated
07/13/2026
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