Provider Demographics
NPI:1104960392
Name:POSTON, MICHAEL GOODMAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GOODMAN
Last Name:POSTON
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 1:457 LANDA ST STE I
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5414
Mailing Address - Country:US
Mailing Address - Phone:830-625-4313
Mailing Address - Fax:830-625-5518
Practice Address - Street 1:457 LANDA ST STE I
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5414
Practice Address - Country:US
Practice Address - Phone:830-625-4313
Practice Address - Fax:830-625-5518
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX133831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice