Provider Demographics
NPI:1386798874
Name:GOLDBERG, BARRY J (DMD MSCD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:J
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:DMD MSCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 590043
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-0001
Mailing Address - Country:US
Mailing Address - Phone:617-244-4654
Mailing Address - Fax:
Practice Address - Street 1:800 BOYLSTON ST STE 200
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02199-8176
Practice Address - Country:US
Practice Address - Phone:617-259-1100
Practice Address - Fax:617-536-6061
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA133361223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics