Individual
MICHAEL S GOLDWASSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 342-3244
(910) 342-3062
Mailing address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 342-3244
(910) 342-3062
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
4061
NC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
036071951
IL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
38955
NC
Other
Enumeration date
07/24/2006
Last updated
12/28/2012
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