Goodman, Mark Wesley
Goodman, Mark Wesley is an individual health care provider with primary practice located at 801 E Tamarack Rd , Altus OK 73521-1231. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Goodman, Mark Wesley can be contacted via phone (580) 482-5424.Contact Information
Primary practice address
801 E Tamarack Rd
Altus OK 73521-1231
Phone: (580) 482-5424
Fax: (580) 482-5429
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 4974 | Oklahoma |
Profile Details
| NPI number | 1851307813 |
|---|---|
| LBN Legal business name | Goodman, Mark Wesley |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Mar 7th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851307813 | NPPES |
| Oklahoma | Other | 794911 | UNITED CONCORDIA # |
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