Goodrich, John
Goodrich, John is an sole proprietor health care provider with primary practice located at 4919 Douglas Ave Suite 12, Des Moines IA 50310. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Goodrich, John can be contacted via phone (515) 276-3664.Contact Information
Primary practice address
4919 Douglas Ave Suite 12
Des Moines IA 50310
Phone: (515) 276-3664
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Endodontics | 1223E0200X | 6461 | Iowa |
Profile Details
| NPI number | 1679622922 |
|---|---|
| LBN Legal business name | Goodrich, John |
| Credentials | DDS MS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 9th, 2007 |
| Last updated | Dec 21st, 2017 - about 7 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 | 1679622922 | NPPES |
| Iowa | MEDICAID | 0162909 | |
| Iowa | Other | 162909 |
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