| Irwin Goodman | |
|
23941 John R Rd Hazel Park MI 48030-1416 | |
| (248) 547-2055 | |
| (248) 547-0054 |
| Full Name | Irwin Goodman |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 23941 John R Rd, Hazel Park, Michigan |
| Authorized Official Name and Position | Irwin Arnold Goodman (DENTIST) |
| Authorized Official Contact | 2485472055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Irwin Goodman 23941 John R Rd Hazel Park MI 48030-1416 Ph: (248) 547-2055 | Irwin Goodman 23941 John R Rd Hazel Park MI 48030-1416 Ph: (248) 547-2055 |
| NPI Number | 1205377694 |
|---|---|
| Provider Enumeration Date | 03/17/2017 |
| Last Update Date | 03/17/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205377694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 14084 (Michigan) | Primary |
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