MEDICARE: F CHARLES GOLDSMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	4361	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1174604847	OTHER	OK	NPI

General Provider Information

NPI Number	:	1780841171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	F CHARLES GOLDSMITH

Provider Business Mailing Address
First Line	:	8383 S PENNSYLVANIA
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159
Country	:	US
Telephone Number	:	405-682-8705
Fax Number	:	405-682-8710

Provider Business Practice Location Address
First Line	:	8383 S PENNSYLVANIA
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159
Country	:	US
Telephone Number	:	405-682-8705
Fax Number	:	405-682-8710

Authorized Official
Title or Position	:	OWNER
Name	:	DR. FREDERIC CHARLES GOLDSMITH
Credential	:	DDS
Telephone Number	:	405-682-8705

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	05/22/2008

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