| John E. Goodrich, D.d.s. | |
|
450 Airbase Rd Mountain Home ID 83647-3483 | |
| (208) 587-3314 | |
| (208) 587-3921 |
| Full Name | John E. Goodrich, D.d.s. |
|---|---|
| Speciality | Dentist |
| Location | 450 Airbase Rd, Mountain Home, Idaho |
| Authorized Official Name and Position | John E Goodrich (OWNER/DENTIST) |
| Authorized Official Contact | 2085873314 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John E. Goodrich, D.d.s. 450 Airbase Rd P.o. Box 660 Mountain Home ID 83647-3483 Ph: (208) 587-3314 | John E. Goodrich, D.d.s. 450 Airbase Rd Mountain Home ID 83647-3483 Ph: (208) 587-3314 |
| NPI Number | 1679864094 |
|---|---|
| Provider Enumeration Date | 04/20/2011 |
| Last Update Date | 04/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679864094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D-2090 (Idaho) | Primary |
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