Individual
DR. CHARLES JOSEPH GOODACRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11092 ANDERSON ST, DEAN'S OFFICE, PH 5518, LOMA LINDA, CA 92350-1706
(909) 558-4683
(909) 558-0483
Mailing address
250 EAST 7TH STREET, SUITE D, UPLAND, CA 91786
(909) 558-4683
(909) 558-0483
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
42510
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149710156
AMER. DENTAL ASSOC. #
CA
01
—
42510
CALIF. DENTAL ASSOC. #
CA
Enumeration date
02/28/2007
Last updated
08/05/2020
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