Provider Demographics
NPI:1083712020
Name:GOLDSTEIN, RONALD TODD (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:TODD
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 CAPE AVE
Mailing Address - Street 2:09 BOX 506
Mailing Address - City:CAPE MAY POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08212-0810
Mailing Address - Country:US
Mailing Address - Phone:609-898-1427
Mailing Address - Fax:
Practice Address - Street 1:ROSEBUD IHS HOSPITAL
Practice Address - Street 2:SOLDIER CREEK ROAD
Practice Address - City:ROSEBUD
Practice Address - State:SD
Practice Address - Zip Code:57570-0400
Practice Address - Country:US
Practice Address - Phone:605-747-3245
Practice Address - Fax:605-747-5348
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021072-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist