Individual
DR. BRODY WAYNE GOODWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7950 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46250-2692
(317) 596-9700
(317) 350-1342
Mailing address
7950 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46250-2692
(317) 596-9700
(317) 350-1342
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012698A
IN
Other
Enumeration date
06/08/2017
Last updated
06/08/2017
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