Provider Demographics
NPI:1588873368
Name:ROBERT S. GOLD DDS PA
Entity type:Organization
Organization Name:ROBERT S. GOLD DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-598-8423
Mailing Address - Street 1:230 ROUTE 206
Mailing Address - Street 2:PO BOX 35
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836
Mailing Address - Country:US
Mailing Address - Phone:973-598-8423
Mailing Address - Fax:
Practice Address - Street 1:230 ROUTE 206
Practice Address - Street 2:BUILDING #1, SUITE #6
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836
Practice Address - Country:US
Practice Address - Phone:973-598-8423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22DI00856200OtherLICENSE