Organization
MID-DEL DENTAL SOLUTIONS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES L GOODWIN DDS (OWNER)
(405) 670-3800
Entity
Organization
Contact information
Practice address
4341 SE 15TH ST, DEL CITY, OK 73115-3001
(405) 670-3800
(405) 670-3803
Mailing address
4341 SE 15TH ST, DEL CITY, OK 73115-3001
(405) 670-3800
(405) 670-3803
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3935
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200108490-A
—
OK
Enumeration date
05/09/2008
Last updated
05/09/2008
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