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Individual

DR. BRYAN M GOLDESBERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1366 E MAIN ST, CARBONDALE, IL 62901-3144
(618) 549-0208
(618) 549-0182
Mailing address
1366 E MAIN ST, CARBONDALE, IL 62901-3144
(618) 549-0208
(618) 549-0182

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-027825
IL

Other

Enumeration date
02/13/2009
Last updated
12/16/2011
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