| L Renee Goodwin Dds Inc | |
|
100 N. Broadway Street Oaktown IN 47561-0269 | |
| (812) 745-4151 | |
| (812) 745-4152 |
| Full Name | L Renee Goodwin Dds Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 N. Broadway Street, Oaktown, Indiana |
| Authorized Official Name and Position | Leah R Goodwin (OWNER) |
| Authorized Official Contact | 8127454151 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| L Renee Goodwin Dds Inc Po Box 269 100 N. Broadway Street Oaktown IN 47561-0269 Ph: (812) 745-4151 | L Renee Goodwin Dds Inc 100 N. Broadway Street Oaktown IN 47561-0269 Ph: (812) 745-4151 |
| NPI Number | 1568643948 |
|---|---|
| Provider Enumeration Date | 11/14/2007 |
| Last Update Date | 04/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568643948 | NPI | - | NPPES |
| 200357310 | Medicaid | IN | |
| 200435290 | Medicaid | IN | |
| 200418020 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12010355A (Indiana) | Primary |