Goodlett, Jeremy Tyler

Goodlett, Jeremy Tyler is an sole proprietor health care provider with primary practice located at 630 Manuel T Freitas Pkwy , San Rafael CA 94903-3106. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Goodlett, Jeremy Tyler can be contacted via phone (415) 479-1273.

Contact Information

Primary practice address
630 Manuel T Freitas Pkwy San Rafael CA 94903-3106
Phone: (415) 479-1273
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 55078 California

Profile Details

NPI number 1285829598
LBN Legal business name Goodlett, Jeremy Tyler
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 10th, 2007
Last updated Jan 16th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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