Organization
BUENHOMBRE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CALEB GRANT GOODMAN DMD (MEMBER/MANAGER)
(520) 429-6957
Entity
Organization
Contact information
Practice address
15581 W MACKENZIE DR, GOODYEAR, AZ 85395-7779
(520) 429-6957
Mailing address
15581 W MACKENZIE DR, GOODYEAR, AZ 85395-7779
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D008966
AZ
Other
Enumeration date
06/17/2014
Last updated
06/17/2014
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