Michael S. Goodman
Pediatric Dentist Dental Public Health
1315 Main St
Willimantic
, Connecticut 06226-1948
Michael S. Goodman
Pediatric Dentist Dental Public Health
1315 Main St
Willimantic
, Connecticut 06226-1948
(860) 668-6622
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About
Features
Specialties
- Dental Public Health
- Pediatric Dentist
Languages spoken
- English
Location
First Address
- Michael S. Goodman
- 131 W Grayling Ln
- Suffield, CT
- Zip : 06078-1960
- Phone : (860) 668-6622
Second Address
- Michael S. Goodman
- 1315 Main St
- Willimantic, CT
- Zip : 06226-1948
- Fax : (860) 423-4629
- Phone : (860) 450-7471
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 1223D0001X | Dental Public Health | 003955 | CT |
| Y | 1223P0221X | Pediatric Dentist | 003955 | CT |
National Provider Identifier
| NPI | 1043275548 |
|---|---|
| Provider Name | Michael S. Goodman |
| First Address | Suffield, CT 06078-1960 |
| Second Address | Willimantic, CT 06226-1948 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/04/2006 |
| Last Update Date | 11/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.