Provider Demographics
NPI:1407999311
Name:GOLDSTEIN, HOWARD MARK (DMD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:MARK
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 1:4555 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-9343
Mailing Address - Country:US
Mailing Address - Phone:610-866-0552
Mailing Address - Fax:610-866-1936
Practice Address - Street 1:4555 EASTON AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-9343
Practice Address - Country:US
Practice Address - Phone:610-866-0552
Practice Address - Fax:610-866-1936
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021892L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist