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KEN GOODWIN DMD PA NPI 1548673320


NPI Information

NPI: 1548673320
Provider Name: KEN GOODWIN, DMD, PA

Doing Business As: PARK PLACE DENTAL

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
403 N THIRD ST
BOONEVILLE, MS
ZIP 38829
Phone: (662) 728-8171
Get Directions

KEN GOODWIN, DMD, PA is a general practice dentist in Booneville, MS. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. KEN GOODWIN, DMD, PA NPI is 1548673320. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Park Place Dental.

The provider's business location address is:

403 N THIRD ST
BOONEVILLE, MS
ZIP 38829-609
Phone: (662) 728-8171
Fax: (662) 728-1093

The provider's authorized official is Ken G Goodwin .
The authorized official title is Owner and has the following contact phone number (662) 728-8171.

The enumeration date for this NPI number is 6/9/2014 and was last updated on 6/9/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice1971-82MISSISSIPPIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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