Individual
DR. HOWARD T GOODPASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1 ELEVENTH AVENUE, SUITE D3, SHCLIMAR, FL 32579
(850) 651-6700
(850) 609-0796
Mailing address
1 ELEVENTH AVENUE, SUITE D3, SHCLIMAR, FL 32579
(850) 651-6700
(850) 609-0796
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11081
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11801
LICENSE NUMBER
FL
01
—
1436581
UNITED CONCORIDA INS CO
FL
01
—
67946
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
10/10/2006
Last updated
07/08/2007
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