Individual
BRIAN JAMES GOODWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
217 S 100 WEST, MONTICELLO, UT 84535
(435) 587-2528
(435) 587-3585
Mailing address
PO BOX 130, MONTEZUMA CREEK, UT 84534-0130
(435) 651-3700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3601858903
UT
122300000X
Dentist
Primary
3601859922
UT
Other
Enumeration date
12/14/2006
Last updated
03/07/2022
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