Michelle  R  Goodwyn    DMD
Contract Details
Dr. Michelle Goodwyn Family Dentistry
Facility name
Provider ID
P000000635
NPI
1669426607
Tax ID
631268509
Effective Date
2/15/2011
Last Updated
6/9/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
3525 Young Meadows Road
Montgomery, AL 36116
United States
County
Montgomery
Phone
3342772332 (Phone)
Billing Details
Address
3525 Young Meadows Road
Montgomery, AL 36116
Billing Phone
3342772332
Specialty Type
Dentistry
Map
Address