Individual
ELIZABETH TANNER GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1317 N KINGS HWY, SUITE 106, MYRTLE BEACH, SC 29577-3636
(843) 626-5437
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS036439
PA
Other
Enumeration date
06/15/2006
Last updated
12/28/2010
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