Individual
AUSTIN GOODYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3299 CLEAR VISTA CT NE STE A, GRAND RAPIDS, MI 49525-9326
(616) 361-0654
Mailing address
5750 BETHANNE DR SW, WYOMING, MI 49418-9787
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901600481APP20
MI
Other
Enumeration date
04/13/2020
Last updated
04/13/2020
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