Organization
PATIENT DENTISTRY,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK WILLIAM GOODMAN D.D.S (PRESIDENT)
(269) 483-9621
Entity
Organization
Contact information
Practice address
113 SOUTH KALAMAZOO ST., WHITE PIGEON, MI 49099
(269) 483-9621
(269) 483-2569
Mailing address
113 SOUTH KALAMAZOO ST., P.O. BOX 695, WHITE PIGEON, MI 49099
(269) 483-9621
(269) 483-2569
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901016419
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134259047
NPI TYPE 1
MI
01
—
2901016419
DENTIST LICENSE
MI
Enumeration date
03/21/2007
Last updated
08/22/2020
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