Individual
DR. AUNDREA GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
714 TIVERTON AVE, LOS ANGELES, CA 90095-8361
(501) 612-5843
Mailing address
1623 W 25TH ST, LOS ANGELES, CA 90007-1529
(501) 612-5843
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/11/2022
Last updated
07/11/2022
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