Individual
DR. JOHN MICHAEL GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1920 S NEVADA AVE, COLORADO SPRINGS, CO 80905
(719) 576-5566
Mailing address
110 BRIGHAM CT, COLORADO SPRINGS, CO 80906-7679
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9514
TN
122300000X
Dentist
DEN.00203480
CO
1223G0001X
General Practice Dentistry
9514
TN
1223G0001X
General Practice Dentistry
Primary
DEN.00203480
CO
Other
Enumeration date
08/09/2012
Last updated
08/15/2018
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