Organization
JOHN E. GOODRICH, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN E GOODRICH D.D.S. (OWNER/DENTIST)
(208) 587-3314
Entity
Organization
Contact information
Practice address
450 AIRBASE RD, MOUNTAIN HOME, ID 83647-3483
(208) 587-3314
(208) 587-3921
Mailing address
450 AIRBASE RD, P.O. BOX 660, MOUNTAIN HOME, ID 83647-3483
(208) 587-3314
(208) 587-3921
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-2090
ID
Other
Enumeration date
04/20/2011
Last updated
04/20/2011
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