Individual
DR. JACK R GOERTZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2405 W APACHE TRL, APACHE JUNCTION, AZ 85120-5202
(410) 726-9335
Mailing address
2124 OLD SCHOOL TRL, MORGANTON, NC 28655-5928
(410) 726-9335
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D01211
AZ
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
05/10/2023
Last updated
07/12/2024
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