Provider Demographics
NPI:1174712152
Name:GOODMAN, AARON PIERCE (DDS)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:PIERCE
Last Name:GOODMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3993 LIMELIGHT AVE.
Mailing Address - Street 2:E
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109
Mailing Address - Country:US
Mailing Address - Phone:720-515-1801
Mailing Address - Fax:720-763-9626
Practice Address - Street 1:3993 LIMELIGHT AVE.
Practice Address - Street 2:E
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109
Practice Address - Country:US
Practice Address - Phone:720-515-1801
Practice Address - Fax:720-763-9626
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice