Provider Demographics
NPI:1548474364
Name:GOODMAN, NATALIE ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:ELIZABETH
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 OLD NORTH RD STE 100A
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76209-1524
Mailing Address - Country:US
Mailing Address - Phone:940-382-9960
Mailing Address - Fax:940-387-7014
Practice Address - Street 1:2412 OLD NORTH RD STE 100A
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76209-1524
Practice Address - Country:US
Practice Address - Phone:940-382-9960
Practice Address - Fax:940-387-7014
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice