Individual
MICHAEL D GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
11045 BROADWAY, SUITE B, CROWN POINT, IN 46307-7474
(219) 662-1200
(219) 662-1888
Mailing address
11045 BROADWAY, CROWN POINT, IN 46307-7473
(219) 662-1200
(219) 662-1888
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7552
IN
Other
Enumeration date
11/16/2007
Last updated
11/16/2007
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