Daniel Tim Goodman in Bolivar - General Practice
Daniel Tim Goodman - NPI 1699835603
Daniel Tim Goodman is a General Practice in Bolivar, Missouri. Daniel Tim Goodman practices all healthcare services and medical treatments related to General Practice. The NPI Number for Daniel Tim Goodman is 1699835603. The last update date is 2007-07-08.
Daniel Tim Goodman's current location address is 305 E Broadway St, Bolivar, Missouri. You can contact this provider via phone number 4173264113 and fax number 4173264115. The mailing address for Daniel Tim Goodman is 305 E Broadway St, Bolivar, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Daniel Tim Goodman |
|---|---|
| Address | 305 E Broadway St, Bolivar, Missouri |
| Phone Number | 4173264113 |
| Fax Number | 4173264115 |
| Sole Proprietor | N |
| Credentials | D.D.S |
NPI Number Detail
| NPI Number | 1699835603 |
|---|---|
| Provider Enumeration Date | 2006-12-11 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 305 E Broadway St |
|---|---|
| City | Bolivar |
| State | Missouri (MO) |
| Post Code | 656131625 |
| Phone Number | 4173264113 |
| Fax Number | 4173264115 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 2005015020 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1750791 | MO | UNITED CONCORDIA |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Daniel Tim Goodman by the Centers for Medicare & Medicaid Services?
The Daniel Tim Goodman has been issued the NPI (National Provider Identifier) 1699835603, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Daniel Tim Goodman?
The Daniel Tim Goodman is physically situated at 305 E Broadway St, in the city of Bolivar, state of MO, with the postal code 656131625.
What is the Daniel Tim Goodman's specialty and taxonomy code?
The Daniel Tim Goodman's specialty is General Practice, and the corresponding taxonomy code is 1223G0001X.
On what date did the Daniel Tim Goodman receive the assignment of its 1699835603 from the Centers for Medicare & Medicaid Services?
The Daniel Tim Goodman was issued its 1699835603 by the Centers for Medicare & Medicaid Services on 2006-12-11.
As of what date were the details pertaining to Daniel Tim Goodman last refreshed?
The information related to the Daniel Tim Goodman, including its address, specialty, and other relevant details, was last updated on 2007-07-08.