Provider Demographics
NPI:1720072671
Name:GOLDSTEIN, PAUL STANLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:STANLEY
Last Name:GOLDSTEIN
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 1:6117 220TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2244
Mailing Address - Country:US
Mailing Address - Phone:718-225-2131
Mailing Address - Fax:
Practice Address - Street 1:6117 220TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-2244
Practice Address - Country:US
Practice Address - Phone:718-225-2131
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0336781223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics