Individual
DR. IRA GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1044 NORTHERN BLVD, SUITE 108, ROSLYN, NY 11576-1514
(516) 484-1123
(516) 484-1127
Mailing address
1044 NORTHERN BLVD, SUITE 108, ROSLYN, NY 11576-1514
(516) 484-1123
(516) 484-1127
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
051130
NY
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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