NPI 1154858033

Mark Goodenough, DDSMD

Practitioner Oral & Maxillofacial Surgery (D.M.D.) Staten Island, NY

Practice location

Address: 256c Mason Ave, Staten Island, NY 10305-3408
Phone: (718) 226-1251
Mailing address: 256 Mason Ave # C, Staten Island, NY 10305-3408

Registered specialties (2)

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence 063143 (NY)

Other Oral & Maxillofacial Surgery providers in New York →

General Practice Physician

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 311698 (NY)

Other General Practice providers in New York →

Registry record

NPI: 1154858033
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 May 2017
Record last updated: 26 Jun 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.