Individual
BRIAN ELLIOTT GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1219 MAIN ST, WEST WARWICK, RI 02893-4834
(401) 615-2804
Mailing address
1219 MAIN ST, WEST WARWICK, RI 02893-4834
(401) 615-2804
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
048569
NY
122300000X
Dentist
12010955A
IN
122300000X
Dentist
22DI02321900
NJ
122300000X
Dentist
30.021372
OH
122300000X
Dentist
Primary
DEN03250
RI
122300000X
Dentist
DS036130
PA
Other
Enumeration date
10/07/2009
Last updated
12/15/2014
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