Individual
RONALD SCOTT GOODMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
28282 DEQUINDRE RD, WARREN, MI 48092-5604
(586) 574-2620
(586) 574-4560
Mailing address
28478 DEQUINDRE RD, WARREN, MI 48092-5605
(586) 574-2620
(586) 574-4560
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15034
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2613950
—
MI
01
—
J800813
BLUE CROSS ID
MI
Enumeration date
01/09/2006
Last updated
12/11/2025
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