Provider Demographics
NPI:1245409804
Name:GOLDSTON DENTAL HEALTH CENTER, PLLC
Entity Type:Organization
Organization Name:GOLDSTON DENTAL HEALTH CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:GOLDSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:806-273-6451
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:BORGER
Mailing Address - State:TX
Mailing Address - Zip Code:79008
Mailing Address - Country:US
Mailing Address - Phone:806-273-6451
Mailing Address - Fax:806-273-6456
Practice Address - Street 1:301 S MCGEE ST
Practice Address - Street 2:
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007
Practice Address - Country:US
Practice Address - Phone:806-273-6451
Practice Address - Fax:806-273-6456
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOLDSTON DENTAL HEALTH CENTER, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-27
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty