Individual
DR. CHARLES MICHAEL GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
28282 DEQUINDRE RD, WARREN, MI 48092-5604
(586) 574-2620
Mailing address
28282 DEQUINDRE RD, WARREN, MI 48092-5604
(586) 574-2620
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8371
MI
Other
Enumeration date
04/25/2012
Last updated
04/25/2012
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