Organization
GOODE FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL GOODE DDS (OWNER)
(541) 830-0043
Entity
Organization
Contact information
Practice address
7417 CRATER LAKE HWY, WHITE CITY, OR 97503-1662
(541) 830-0043
Mailing address
7417 CRATER LAKE HWY, WHITE CITY, OR 97503-1662
(541) 830-0043
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9436
OR
Other
Enumeration date
02/13/2012
Last updated
02/13/2012
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