Gothelf, Craig

Gothelf, Craig is an individual health care provider with primary practice located at 3730 83Rd St Dental Office, Jackson Heights NY 11372-7154. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Gothelf, Craig can be contacted via phone (718) 639-6966.

Contact Information

Primary practice address
3730 83Rd St Dental Office Jackson Heights NY 11372-7154
Phone: (718) 639-6966
Fax: (718) 639-8478
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 037574 New York

Profile Details

NPI number 1154311298
LBN Legal business name Gothelf, Craig
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2005
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154311298 NPPES
New York MEDICAID 00780570

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