Organization
IRA GOLDBERG, D.M.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRA ELLIOT GOLDBERG D.M.D. (MEMBER)
(516) 484-1123
Entity
Organization
Contact information
Practice address
1044 NORTHERN BLVD, SUITE 108, ROSLYN, NY 11576-1514
(516) 484-1123
Mailing address
1044 NORTHERN BLVD, SUITE 108, ROSLYN, NY 11576-1514
(516) 484-1123
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
051130
NY
Other
Enumeration date
09/05/2007
Last updated
09/05/2007
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