Individual
DR. EVAN B GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
115 W MAPLE AVE, LIBERTYVILLE, IL 60048-2119
(847) 362-2980
(847) 362-2704
Mailing address
115 W MAPLE AVE, LIBERTYVILLE, IL 60048-2119
(847) 362-2980
(847) 362-2704
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-012704
IL
Other
Enumeration date
07/25/2006
Last updated
07/08/2007
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