Provider Demographics
NPI:1033308754
Name:GOLOVAN, GARY (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:
Last Name:GOLOVAN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28790 CHAGRIN BLVD
Mailing Address - Street 2:SUITE # 250
Mailing Address - City:WOODMERE
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4638
Mailing Address - Country:US
Mailing Address - Phone:216-591-1916
Mailing Address - Fax:216-591-0835
Practice Address - Street 1:28790 CHAGRIN BLVD
Practice Address - Street 2:SUITE # 250
Practice Address - City:WOODMERE
Practice Address - State:OH
Practice Address - Zip Code:44122-4638
Practice Address - Country:US
Practice Address - Phone:216-591-1916
Practice Address - Fax:216-591-0835
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH185091223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics