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Individual

DR. COREY L GOLDSTEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
14 MAPLE ST, SUITE 105, PORT WASHINGTON, NY 11050-2946
(516) 767-9344
(516) 767-3906
Mailing address
14 MAPLE ST., SUITE 105, PORT WASHINGTON, NY 11050
(516) 767-9344
(516) 767-3906

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
041652
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01385437
NY
Enumeration date
01/31/2007
Last updated
07/08/2007
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