Provider Demographics
NPI:1982814612
Name:GOODGAL BEIM, PAMELA JANE (DDS)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JANE
Last Name:GOODGAL BEIM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 COURTYARD DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-4258
Mailing Address - Country:US
Mailing Address - Phone:908-722-0321
Mailing Address - Fax:
Practice Address - Street 1:811 COURTYARD DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4258
Practice Address - Country:US
Practice Address - Phone:908-722-0321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ12577122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist