MEDICARE: DR. ALLAN L. GOINS JR. DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	12007859A	IN

General Provider Information

NPI Number	:	1710001045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLAN L. GOINS JR. DDS

Provider Business Mailing Address
First Line	:	67 LONG ST
Second Line	:
City	:	NORTH VERNON
State	:	IN
Zip	:	47265-2313
Country	:	US
Telephone Number	:	812-346-5451
Fax Number	:	812-346-8456

Provider Business Practice Location Address
First Line	:	67 LONG ST
Second Line	:
City	:	NORTH VERNON
State	:	IN
Zip	:	47265-2313
Country	:	US
Telephone Number	:	812-346-5451
Fax Number	:	812-346-8456

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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