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
122300000X
Dentist
Primary
12014038A
IN
1223G0001X
General Practice Dentistry
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
05/18/2026
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