Individual
JENNIFER G. GOODALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1037 MAIN ST, HUDSON RIVER HEALTHCARE, INC., PEEKSKILL, NY 10566-2913
(914) 734-8800
(914) 734-8799
Mailing address
1200 BROWN ST, 4TH FLOOR - CREDENTIALING, PEEKSKILL, NY 10566-3617
(914) 734-8858
(914) 734-8745
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
052172
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00473038
—
NY
Enumeration date
07/17/2006
Last updated
07/09/2007
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