Organization
DR JACOB GOERTZ DMD LLC
Active
Other names
Goertz Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB GOERTZ DMD (OWNER)
(503) 860-2625
Entity
Organization
Contact information
Practice address
617 HIGH ST STE 201, OREGON CITY, OR 97045-2228
(503) 656-4123
Mailing address
617 HIGH ST STE 201, OREGON CITY, OR 97045-2228
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093293946
—
OR
Enumeration date
12/04/2019
Last updated
12/04/2019
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