Provider Demographics
NPI:1306188040
Name:GOLDSCHEIN, HARRY J (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:J
Last Name:GOLDSCHEIN
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 1:1120 STATE ROAD 436
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707
Mailing Address - Country:US
Mailing Address - Phone:407-977-7079
Mailing Address - Fax:407-677-1022
Practice Address - Street 1:1500 BEVILLE RD STE 403
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114
Practice Address - Country:US
Practice Address - Phone:386-253-6634
Practice Address - Fax:386-258-8775
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN8342122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1811085509OtherNPI