Individual
DR. CHARLES LINDY GOODWIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10001 S PENN, M240, OKALAHOMA CITY, OK 73159
(405) 691-0836
(405) 691-0480
Mailing address
10612 FAIWAY AVE, OKLAHOMA CITY, OK 73170
(405) 691-3048
(405) 691-0480
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3935
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1309163
UNITED CONCORDIA
—
01
—
194550
UNITED CONCORDIA
—
Enumeration date
03/01/2006
Last updated
07/08/2007
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