Individual
LAURIE ALLYN GOLDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MD
Contact information
Practice address
7136 UNIVERSITY AVE NE, FRIDLEY, MN 55432-3100
(763) 574-1639
Mailing address
7136 UNIVERSITY AVE NE, FRIDLEY, MN 55432-3100
(763) 574-1639
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D11067
MN
Other
Enumeration date
02/16/2007
Last updated
07/08/2007
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