Individual
ROSALIE GOODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DT, RDH
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT0001
OR
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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