Provider Demographics
NPI:1235215112
Name:GOLDMAN, EDWARD MICHAELS (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:MICHAELS
Last Name:GOLDMAN
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 1:250 ENGLAR RD.
Mailing Address - Street 2:CARROLL PLAZA SHOPPING CENTER, SUITE 5
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-4601
Mailing Address - Country:US
Mailing Address - Phone:410-848-0600
Mailing Address - Fax:
Practice Address - Street 1:250 ENGLAR RD
Practice Address - Street 2:CARROLL PLAZA SHOPPING CENTER, SUITE 5
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-2929
Practice Address - Country:US
Practice Address - Phone:410-848-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD43191223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics