Organization
DUSTIN V. GOODWIN D.D.S. P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUSTIN VINAL GOODWIN D.D.S. (PRESIDENT)
(435) 257-7016
Entity
Organization
Contact information
Practice address
75 E 1400 S, GARLAND, UT 84312-9316
(435) 257-7016
(435) 257-4590
Mailing address
75 E 1400 S, PO BOX 99, GARLAND, UT 84312-9316
(435) 257-7016
(435) 257-4590
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3532
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1319810
UNITED CONCORDIA/TRICARE
—
01
—
6H429
BLUE CROSS
—
05
—
806174600
—
ID
Enumeration date
09/16/2006
Last updated
07/08/2015
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