Provider Demographics
NPI:1437568359
Name:GOLIK, BENJAMIN MARTIN (DDS)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:MARTIN
Last Name:GOLIK
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 1:5113 E LACEY GARDEN LOOP
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-2605
Mailing Address - Country:US
Mailing Address - Phone:314-604-7354
Mailing Address - Fax:
Practice Address - Street 1:3510 MAIN ST STE E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-9568
Practice Address - Country:US
Practice Address - Phone:832-968-8726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31449122300000X
NY50 0574341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice