Provider Demographics
NPI:1659080554
Name:CRAIG A GOLIBER DMD PLLC
Entity Type:Organization
Organization Name:CRAIG A GOLIBER DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOLIBER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:802-878-4869
Mailing Address - Street 1:68 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-3772
Mailing Address - Country:US
Mailing Address - Phone:802-878-4869
Mailing Address - Fax:
Practice Address - Street 1:68 MAPLE ST
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-3772
Practice Address - Country:US
Practice Address - Phone:802-878-4869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty