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Individual
DR. MARK GOODENOUGH
Active
Individual
DR. MARK GOODENOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
063143
NY
208D00000X
General Practice Physician
311698
NY
Other
Enumeration date
05/22/2017
Last updated
06/26/2024
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