Individual
DR. MARY THRESA GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
9513 Q ST, RALSTON, NE 68127-5201
(402) 339-6400
Mailing address
9513 Q ST, RALSTON, NE 68127-5201
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7393
NE
Other
Enumeration date
06/15/2017
Last updated
03/17/2018
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