Provider Demographics
NPI:1871661900
Name:GOINS, CLAY PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLAY
Middle Name:PAUL
Last Name:GOINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1720 GUNBARREL RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3192
Mailing Address - Country:US
Mailing Address - Phone:423-954-9511
Mailing Address - Fax:423-954-9912
Practice Address - Street 1:1720 GUNBARREL RD
Practice Address - Street 2:SUITE 310
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3192
Practice Address - Country:US
Practice Address - Phone:423-954-9511
Practice Address - Fax:423-954-9912
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0130671223P0221X
TN86001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA124812432AMedicaid
GA100199OtherAVESIS MEDICAID
GA9181145OtherDORAL MEDICAID