Provider Demographics
NPI:1295366599
Name:DANIEL N. GOLDWEIT, D.M.D., LLC
Entity Type:Organization
Organization Name:DANIEL N. GOLDWEIT, D.M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:NATHAN
Authorized Official - Last Name:GOLDWEIT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-315-4113
Mailing Address - Street 1:285 GRAND AVE BLDG 5
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4369
Mailing Address - Country:US
Mailing Address - Phone:201-315-4113
Mailing Address - Fax:
Practice Address - Street 1:285 GRAND AVE BLDG 5
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4369
Practice Address - Country:US
Practice Address - Phone:201-315-4113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental