Individual
GLENN RICHARD GOODRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS,MSD.
Contact information
Practice address
54 PHILOMETHIAN ST, CHAGRIN FALLS, OH 44022-2926
(440) 247-9444
Mailing address
54 PHILOMETHIAN ST, CHAGRIN FALLS, OH 44022-2926
(440) 247-9444
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30-018096
OH
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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