Individual
MICHAEL S. GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D. D. S.
Contact information
Practice address
1315 MAIN ST, WILLIMANTIC, CT 06226-1948
(860) 450-7471
(860) 423-4629
Mailing address
131 W GRAYLING LN, SUFFIELD, CT 06078-1960
(860) 668-6622
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
003955
CT
1223P0221X
Pediatric Dentistry
Primary
003955
CT
Other
Enumeration date
04/18/2006
Last updated
07/11/2007
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