Organization
ROBERT C. GOLDTRAP,DDS,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT C GOLDTRAP D.D.S. (OWNER)
(479) 484-7645
Entity
Organization
Contact information
Practice address
8309 PHOENIX AVENUE, FORT SMITH, AR 72903-0001
(479) 484-7645
(479) 484-1551
Mailing address
8309 PHOENIX AVENUE, FORT SMITH, AR 72903-0001
(479) 484-7645
(479) 484-1551
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160840631
—
AR
01
—
464681
UNITED CONCORDIA
AR
01
—
5U751
BLUE CROSS BLUE SHIELD
AR
Enumeration date
04/19/2007
Last updated
07/28/2010
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