# DR. MARK GOODENOUGH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1154858033
- **Gender:** Man
- **Credential:** DDS, MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 063143 | NY | Yes |
| 208D00000X | General Practice Physician | 311698 | NY | — |

## Other

- **Enumeration date:** 05/22/2017
- **Last updated:** 06/26/2024