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Individual
DR. ROBERT I. GOODMAN JR.
Active
Individual
DR. ROBERT I. GOODMAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6563
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
263217
TRIGON BCBS
KY
01
—
6563
LICENSE
KY
01
—
802932
UNITED CONCORDIA
KY
01
—
E933
BCBS FEDERAL
KY
Enumeration date
02/21/2007
Last updated
07/08/2007
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