Individual
DR. MICHELLE POTTER GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3008 S CHURCH ST STE B, BURLINGTON, NC 27215-5686
(336) 584-7004
(336) 584-3515
Mailing address
510 DAY BREAK SQ, GREENSBORO, NC 27455-3453
(336) 282-2009
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6765
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5064324
AETNA
NC
05
—
8995749
—
NC
01
—
95749
BCBS
NC
Enumeration date
12/11/2006
Last updated
07/09/2007
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