Individual
JASON MICHAEL GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6520 N 7TH AVE STE 5, PHOENIX, AZ 85013
(602) 277-5304
Mailing address
8107 E VIA DEL FUTURO, SCOTTSDALE, AZ 85258-3712
(704) 530-8406
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
11912
NC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D012125
AZ
Other
Enumeration date
06/14/2016
Last updated
10/09/2024
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