Provider Demographics
NPI:1043353899
Name:DRS ROBERT AND IRA GOLDSTINE
Entity Type:Organization
Organization Name:DRS ROBERT AND IRA GOLDSTINE
Other - Org Name:ROBERT S. GOLDSTINE IRA L. GOLDSTINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VADINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-448-7440
Mailing Address - Street 1:343 DUTCH NECK RD
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1301
Mailing Address - Country:US
Mailing Address - Phone:609-448-7440
Mailing Address - Fax:609-448-0044
Practice Address - Street 1:343 DUTCH NECK RD
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1301
Practice Address - Country:US
Practice Address - Phone:609-448-7440
Practice Address - Fax:609-448-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ81401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty