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Individual

DR. BROCK AARON GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
702 C ST, SAN DIEGO, CA 92101-5308
(408) 621-5779
Mailing address
3722 LAS VEGAS BLVD S, 2104E, LAS VEGAS, NV 89158-4301
(408) 621-5779

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
59901
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6023
NV

Other

Enumeration date
08/18/2010
Last updated
09/26/2013
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