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General NPI Number Information
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NPI Number | 1932278629
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Entity Type | Individual
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Provider Name | BARRY MORTON GOLDMAN DDS. MS.
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 1430 JOHN WESLEY GILBERT DRIVE
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City | AUGUSTA
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State | GA
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Zip | 30912-0001
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Country | US
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Telephone | 706-721-2371
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Fax |
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Provider Business Mailing Address
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Address Line | 108 YUCCA AVE
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City | NORTH AUGUSTA
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State | SC
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Zip | 29860-9229
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Country | US
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Telephone | 803-634-7180
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Fax |
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DE60399541
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DN006851
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 051185
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 61328
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License Number State | CA
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