Provider Demographics
NPI:1710001045
Name:GOINS, ALLAN L JR (DDS)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:L
Last Name:GOINS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 LONG ST
Mailing Address - Street 2:
Mailing Address - City:NORTH VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47265-2313
Mailing Address - Country:US
Mailing Address - Phone:812-346-5451
Mailing Address - Fax:812-346-8456
Practice Address - Street 1:67 LONG ST
Practice Address - Street 2:
Practice Address - City:NORTH VERNON
Practice Address - State:IN
Practice Address - Zip Code:47265-2313
Practice Address - Country:US
Practice Address - Phone:812-346-5451
Practice Address - Fax:812-346-8456
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007859A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist