Individual
CHARLES J GOODIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7520 MONTGOMERY BLVD NE, SUITE E1, ALBUQUERQUE, NM 87109
(505) 797-1212
(505) 823-1831
Mailing address
7520 MONTGOMERY BLVD NE, SUITE E1, ALBUQUERQUE, NM 87109
(505) 797-1212
(505) 823-1831
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DD1868
NM
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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