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NPI Code Detail

MEDICARE: MARTIN S GOLDBERG DDS PC

MEDICARE: MARTIN S GOLDBERG DDS PC
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
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryDS013248LPA

General Provider Information

NPI Number : 1639262462
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARTIN S GOLDBERG DDS PC
Provider Business Mailing Address
First Line : 203 S HIGH ST
Second Line :
City : WEST CHESTER
State : PA
Zip : 19382-3403
Country : US
Telephone Number : 610-696-8966
Fax Number : 610-436-4903
Provider Business Practice Location Address
First Line : 203 S HIGH ST
Second Line :
City : WEST CHESTER
State : PA
Zip : 19382-3403
Country : US
Telephone Number : 610-696-8966
Fax Number : 610-436-4903
Authorized Official
Title or Position : PRESIDENT
Name : DR. MARTIN S GOLDBERG
Credential : DDS PC
Telephone Number : 610-696-8966
Provider Enumeration Date : 10/02/2006
Last Update Date : 08/22/2020

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Directions to “MARTIN S GOLDBERG DDS PC ” Practice Location

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