Provider Demographics
NPI:1659387645
Name:GOLD, BETH ANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANNE
Last Name:GOLD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:BETH
Other - Middle Name:ANNE
Other - Last Name:MAHAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5100 GROVE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-4492
Mailing Address - Country:US
Mailing Address - Phone:360-659-6732
Mailing Address - Fax:360-653-6835
Practice Address - Street 1:5100 GROVE ST
Practice Address - Street 2:SUITE A
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4492
Practice Address - Country:US
Practice Address - Phone:360-659-6732
Practice Address - Fax:360-653-6835
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000067671223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics