Individual
DR. HARRY H GOODWIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
509 BON AMI ST, DERIDDER, LA 70634-4925
(337) 463-3272
(337) 463-3288
Mailing address
114 RAYMOND DR, DERIDDER, LA 70634-5806
(337) 463-9289
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2448
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1824488
—
LA
Enumeration date
09/06/2006
Last updated
07/08/2007
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