Organization
LD-TUSCALOOSA, LLC
Active
Other names
New Image Family Dentistry, LLC, Forest Lake Dental, Rodney L. Goins, DMD, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN S DAIGNEAULT BA, MA (ADMIN DIRECTOR)
(256) 783-9468
Entity
Organization
Contact information
Practice address
1434 2ND CT E, TUSCALOOSA, AL 35401-3200
(205) 752-5400
(662) 586-2995
Mailing address
1434 2ND CT E, TUSCALOOSA, AL 35401-3200
(205) 752-5400
(205) 752-5311
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/02/2022
Last updated
07/03/2023
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