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NPI Code Detail

MEDICARE: DR. JOSHUA M GOLDMAN DDS

MEDICARE: DR. JOSHUA M GOLDMAN DDS
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
1122300000XDentist006920CT

General Provider Information

NPI Number : 1386895803
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSHUA M GOLDMAN DDS
Provider Business Mailing Address
First Line : 250 LAMBERTON RD
Second Line :
City : WINDSOR
State : CT
Zip : 06095-2129
Country : US
Telephone Number : 860-688-3663
Fax Number : 860-688-2111
Provider Business Practice Location Address
First Line : 250 LAMBERTON RD
Second Line :
City : WINDSOR
State : CT
Zip : 06095-2129
Country : US
Telephone Number : 860-688-3663
Fax Number : 860-688-2111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2008
Last Update Date : 10/02/2008

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