Individual
DR. ZACHARY JACOB GOMOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
925 E UNIVERSITY DR, GRANGER, IN 46530-4465
(574) 277-7733
Mailing address
925 E UNIVERSITY DR, GRANGER, IN 46530-4465
(574) 277-7733
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.033072
IL
1223G0001X
General Practice Dentistry
Primary
2901601151
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4438474
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
05/27/2021
Last updated
04/01/2026
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