Provider Demographics
NPI:1679842397
Name:GOLDVARG, ARTHUR L (DDS)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:L
Last Name:GOLDVARG
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 1:1003 N POINT BLVD
Mailing Address - Street 2:SUITE 601
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3662
Mailing Address - Country:US
Mailing Address - Phone:410-288-2040
Mailing Address - Fax:410-288-2606
Practice Address - Street 1:1003 N POINT BLVD
Practice Address - Street 2:SUITE 601
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3662
Practice Address - Country:US
Practice Address - Phone:410-288-2040
Practice Address - Fax:410-288-2606
Is Sole Proprietor?:No
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD73451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice