Individual
DR. PHILLIP M GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
105 STATE PARK RD, GREENVILLE, SC 29609-2914
(864) 271-1156
Mailing address
540 OLD HARBOR CT, DAYTON, OH 45458-2878
(937) 823-3441
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7132
SC
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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