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Organization

BRETT S. GOYMERAC DDS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRETT S. GOYMERAC DDS (OWNER/DDS)
(906) 228-4646
Entity
Organization

Contact information

Practice address
760 W WASHINGTON ST, MARQUETTE, MI 49855-4138
(906) 228-4646
(906) 228-4166
Mailing address
760 W WASHINGTON ST, MARQUETTE, MI 49855-4138
(906) 228-4646
(906) 228-4166

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D801178
BLUE CROSS BLUE SHIELD
MI
Enumeration date
11/02/2006
Last updated
10/30/2007
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