Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0300X | Periodontist | 0401411357 | VA |
N | 1223P0300X | Periodontist | 12987 | MD |
Y | 1223P0300X | Periodontist | DN16170 | FL |
NPI | 1043361801 |
---|---|
Provider Name | Dr. Shari B Goldstein |
First Address | Boca Raton, FL 33494 |
Second Address | Boca Raton, FL 33496-3483 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |