| NPI | 1841907466 |
|---|---|
| Former Legal Business Name | NEW IMAGE FAMILY DENTISTRY, LLC |
| Former Legal Business Name | RODNEY L. GOINS, DMD, P.C. |
| Doing Business As | FOREST LAKE DENTAL |
| Entity Type | Organization |
| Authorized Contact | LAUREN S DAIGNEAULT Admin Director 256-783-9468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2023-07-03 |