Provider Demographics
NPI:1346337557
Name:CENTRAL DENTISTRY, PC
Entity Type:Organization
Organization Name:CENTRAL DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOODSPEED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:205-870-1363
Mailing Address - Street 1:2901 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2505
Mailing Address - Country:US
Mailing Address - Phone:205-870-1363
Mailing Address - Fax:
Practice Address - Street 1:2901 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-2505
Practice Address - Country:US
Practice Address - Phone:205-870-1363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL49841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty