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General NPI Number Information
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NPI Number | 1033258579
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Entity Type | Individual
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Provider Name | LOREN RICHARD GOLDSTEIN DDS
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Gender | Male
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 18 DAVISON AVE
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City | OCEANSIDE
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State | NY
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Zip | 11572-2237
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Country | US
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Telephone | 516-766-5250
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Fax | 516-766-7594
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Provider Business Mailing Address
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Address Line | 127 MURRAY DR
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City | OCEANSIDE
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State | NY
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Zip | 11572-5723
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Country | US
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Telephone | 516-766-5250
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Fax | 516-766-7594
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 37776
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License Number State | NY
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