Provider Demographics
NPI:1043216245
Name:GOLDBERG, MARSHAL D (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARSHAL
Middle Name:D
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 N CENTRAL EXPY
Mailing Address - Street 2:STE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-4423
Mailing Address - Country:US
Mailing Address - Phone:214-890-7777
Mailing Address - Fax:214-890-7782
Practice Address - Street 1:8401 N CENTRAL EXPY
Practice Address - Street 2:STE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-4423
Practice Address - Country:US
Practice Address - Phone:214-890-7777
Practice Address - Fax:214-890-7782
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX125721223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics