Goldstein, Mark
Goldstein, Mark is an individual health care provider with primary practice located at 6404 Roosevelt Blvd , Philadelphia PA 19149-2943. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Goldstein, Mark can be contacted via phone (215) 743-3700.Contact Information
Primary practice address
6404 Roosevelt Blvd
Philadelphia PA 19149-2943
Phone: (215) 743-3700
Fax: (215) 743-3706
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | DS18048L | Pennsylvania |
Profile Details
| NPI number | 1144214511 |
|---|---|
| LBN Legal business name | Goldstein, Mark |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144214511 | NPPES |
| Pennsylvania | MEDICAID | 00529928 |
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