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Contact Information

FREDISHA M GOODFELLOW, DMD
900 N 7TH ST
WEST MEMPHIS, AR72301-2001
 Phone: 870-733-6334
 Fax: 870-735-4379
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for FREDISHA M GOODFELLOW · (Female)

NPI Number 1982969853
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 07/06/2012
Last updated 04/17/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • AR License # 3873
  • TN License # 9471
  • TX License # 28054
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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