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Organization
L RENEE GOODWIN DDS INC
Active
Organization
L RENEE GOODWIN DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEAH R GOODWIN DDS (OWNER)
(812) 745-4151
Entity
Organization
Contact information
Practice address
100 N. BROADWAY STREET, OAKTOWN, IN 47561-0269
(812) 745-4151
(812) 745-4152
Mailing address
PO BOX 269, 100 N. BROADWAY STREET, OAKTOWN, IN 47561-0269
(812) 745-4151
(812) 745-4152
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010355A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200357310
—
IN
05
—
200418020
—
IN
05
—
200435290
—
IN
Enumeration date
11/14/2007
Last updated
04/06/2015
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