Provider Demographics
NPI:1598973406
Name:LAWRENCE E. GOODMAN, D.M.D., P.C.
Entity Type:Organization
Organization Name:LAWRENCE E. GOODMAN, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-784-3330
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-0067
Mailing Address - Country:US
Mailing Address - Phone:781-784-3330
Mailing Address - Fax:781-784-3363
Practice Address - Street 1:450 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-1172
Practice Address - Country:US
Practice Address - Phone:781-784-3330
Practice Address - Fax:781-784-3363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA176721223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty