Organization Name: | VERNON J. GOIN D.D.S. S.C. |
NPI Number: | 1497896492 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VERNON JOHN GOIN (DENTIST) |
Mailing Address: | 964 W Ryan St Suite D Brillion |
State: | WI US |
Postal Code: | 541101076 |
Phone Number: | 9207563313 |
Fax Number: | |
NPI Enumeration Date: | 02/11/2007 |
NPI Last Update Date: | 01/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 1437G |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |