Individual
DR. JACKSON PONTZ GOETHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7373 E 21ST ST, INDIANAPOLIS, IN 46219-1753
(317) 357-7373
Mailing address
2229 MAPLELEAF DR, MIDLAND, MI 48640-6715
(989) 859-9333
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12014137A
IN
Other
Enumeration date
06/27/2023
Last updated
04/22/2024
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