Individual
DR. JONATHAN F GOLDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
701 COTTAGE GROVE RD, BLOOMFIELD, CT 06002-3080
(860) 242-6142
(860) 243-5211
Mailing address
701 COTTAGE GROVE RD, BLOOMFIELD, CT 06002-3080
(860) 242-6142
(860) 243-5211
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
CT7211
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0146671003
CIGNA
CT
01
—
0146671004
CIGNA
CT
01
—
020007211CT03
BLUE CROSS BLUE SHIELD
CT
01
—
020007211CT04
BLUE CROSS BLUE SHIELD
CT
01
—
190000684
PTAN
CT
01
—
4227283
AETNA
CT
01
—
750677
CONNECTICARE
CT
01
—
83982
AETNA
CT
01
—
P1274198
OXFORD
CT
Enumeration date
06/27/2006
Last updated
03/05/2015
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