Individual
DR. MICHAEL RAY GOINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1 WAHOO AVE, GROTON, CT 06349-2324
(860) 694-3736
Mailing address
148 PROTEUS AVE, GROTON, CT 06340-2836
(318) 680-2917
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS041475
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DS041475
GOVERNMENT
PA
Enumeration date
07/26/2017
Last updated
07/26/2017
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