Individual
DR. JAY HARVEY GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
375 WILLARD AVE, NEWINGTON, CT 06111-2300
(860) 665-0444
Mailing address
375 WILLARD AVE, NEWINGTON, CT 06111-2300
(860) 665-0444
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4731
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4731
DENTAL STATE LICENSE
CT
Enumeration date
04/06/2007
Last updated
07/08/2007
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