Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | D10815 | OR |
NPI | 1104319805 |
---|---|
Provider Name | Dr. Cari Nicole Goyne |
First Address | Eugene, OR 97401-4259 |
Second Address | Eugene, OR 97401-4259 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2018 |
Last Update Date | 08/06/2018 |