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Individual

DR. KIM E GOLDMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
NYU SCHOOL OF DENTISTRY, 345 EAST 24TH STREET, NEW YORK, NY 10010-4086
(212) 998-9660
Mailing address
1313 LYNDON LN, SUITE 214, LOUISVILLE, KY 40222-7351
(502) 582-3750

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
06323
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
056681
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
42152
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
6323
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03658220
NY
05
200365950
IN
05
64063233
KY
Enumeration date
03/24/2006
Last updated
11/27/2018
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