MEDICARE: ROBERT 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
1	122300000X	Dentist	0013972	FL

General Provider Information

NPI Number	:	1871766550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT GOLDMAN DDS

Provider Business Mailing Address
First Line	:	306 RESORT LN
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-7050
Country	:	US
Telephone Number	:	561-622-0010
Fax Number	:

Provider Business Practice Location Address
First Line	:	4512 N FLAGLER DR
Second Line	:	SUITE 301
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3839
Country	:	US
Telephone Number	:	561-863-9894
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2008
Last Update Date	:	06/18/2009

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