Individual
EVAN GOLDSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
100 BROOKLYN AVE, SUITE 1P-R, FREEPORT, NY 11520-3043
(516) 378-7880
Mailing address
100 BROOKLYN AVE, SUITE 1P-R, FREEPORT, NY 11520-3043
(516) 378-7880
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
035631-1
NY
Other
Enumeration date
03/05/2008
Last updated
03/05/2008
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