# SAMUEL GOODLOE III DDS MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518242320
- **Authorized official:** DR. SANUEL GOODLOE III DDS, MD (OWNER)
- **Authorized official phone:** (716) 626-0001

## Contact information

- **Practice address:** 1321 MILLERSPORT HWY, SUITE 201, WILLIAMSVILLE, NY 14221-2900
- **Practice address phone:** (716) 626-0001
- **Mailing address:** 1321 MILLERSPORT HWY, SUITE 201, WILLIAMSVILLE, NY 14221-2900
- **Mailing address phone:** (716) 626-0001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 044038 | NY | Yes |

## Other

- **Enumeration date:** 10/13/2011
- **Last updated:** 10/13/2011