Individual
DR. CHARLES HARRELL GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
2835 N SHEFFIELD AVE, SUITE 408, CHICAGO, IL 60657
(773) 327-1613
(773) 327-3642
Mailing address
2835 N SHEFFIELD AVE, SUITE 408, CHICAGO, IL 60657
(773) 327-1613
(773) 327-3642
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
12009427
IN
1223P0300X
Periodontics
Primary
—
IL
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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