Individual
DR. JONATHAN BRENT GOOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
285 UPTOWN BLVD APT 309, ALTAMONTE SPRINGS, FL 32701-3496
(904) 304-1887
Mailing address
285 UPTOWN BLVD APT 309, ALTAMONTE SPRINGS, FL 32701-3496
(904) 304-1887
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN17917
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000956600
—
FL
Enumeration date
07/09/2007
Last updated
12/22/2009
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