Provider Demographics
NPI:1811219033
Name:GOLDBERG, STEVEN G (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:G
Last Name:GOLDBERG
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 1:7301A W PALMETTO PARK RD
Mailing Address - Street 2:SUITE 303-C
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3409
Mailing Address - Country:US
Mailing Address - Phone:561-347-8266
Mailing Address - Fax:
Practice Address - Street 1:7301A W PALMETTO PARK RD
Practice Address - Street 2:SUITE 303-C
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3409
Practice Address - Country:US
Practice Address - Phone:561-347-8266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00115971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice