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General NPI Number Information
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NPI Number | 1306063391
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Entity Type | Organization
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Legal Business Name | ROBERT C. GOLDTRAP,DDS,INC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 8309 PHOENIX AVENUE
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City | FORT SMITH
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State | AR
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Zip | 72903-0001
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Country | US
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Telephone | 479-484-7645
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Fax | 479-484-1551
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Provider Business Mailing Address
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Address Line | 8309 PHOENIX AVENUE
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City | FORT SMITH
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State | AR
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Zip | 72903-0001
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Country | US
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Telephone | 479-484-7645
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Fax | 479-484-1551
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT C GOLDTRAP
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Credential | D.D.S.
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Telephone | 479-484-7645
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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 |
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License Number State |
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