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General NPI Number Information
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NPI Number | 1104374644
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Entity Type | Organization
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Legal Business Name | GOLDENBERG ORTHODONTICS, P.A.
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9250 GLADES RD SUITE 208
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City | BOCA RATON
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State | FL
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Zip | 33434-3958
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Country | US
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Telephone | 561-756-9227
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Fax | 561-756-9215
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Provider Business Mailing Address
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Address Line | 9250 GLADES RD SUITE 208
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City | BOCA RATON
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State | FL
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Zip | 33434-3958
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Country | US
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Telephone | 561-756-9227
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Fax | 561-756-9215
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARC GOLDENBERG
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Credential | D.D.S.
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Telephone | 561-756-9227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN21140
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License Number State | FL
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