Individual
MS. PAMELA GOODLIFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
585 WEST BOOTH, LAVA HOT SPRINGS, ID 83246-0458
(208) 776-5929
(208) 776-5011
Mailing address
PO BOX 458, 585 W BOOTH, LAVA HOT SPRINGS, ID 83246-0458
(208) 776-5929
(208) 776-5011
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3845
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8070282
—
ID
Enumeration date
11/30/2006
Last updated
04/30/2015
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