Organization
GOSHEN MEDICAL CENTER, INC.
Active
Other names
Clinton Dental Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMMY M HOWARD (SITE LEADER)
(910) 267-0951
Entity
Organization
Contact information
Practice address
908 N US HIGHWAY 421, CLINTON, NC 28328-0410
(910) 267-0951
(910) 267-0954
Mailing address
908 US HWY 421 N, CLINTON, NC 28328-0410
(910) 299-0991
(910) 299-0995
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5914123
—
NC
Enumeration date
03/30/2010
Last updated
05/11/2012
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