Individual
DR. JACEY ELIZABETH GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4850 HIGHWAY 19 S, ZEBULON, GA 30295-3486
(404) 617-9695
Mailing address
PO BOX 520, MILNER, GA 30257-0520
(404) 617-9695
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013095
GA
Other
Enumeration date
08/08/2007
Last updated
08/08/2007
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