MEDICARE: DR. DAREN LANE GOIN

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	1223G0001X	General Practice Dentistry	5179	OR

General Provider Information

NPI Number	:	1760488977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAREN LANE GOIN

Provider Business Mailing Address
First Line	:	505 N 2ND AVE
Second Line	:
City	:	STAYTON
State	:	OR
Zip	:	97383-1715
Country	:	US
Telephone Number	:	503-769-3366
Fax Number	:	503-769-5501

Provider Business Practice Location Address
First Line	:	505 N 2ND AVE
Second Line	:
City	:	STAYTON
State	:	OR
Zip	:	97383-1715
Country	:	US
Telephone Number	:	503-769-3366
Fax Number	:	503-769-5501

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. DAREN LANE GOIN ” Practice Location

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