Individual
DR. JEROME J GOMOLKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5236 W BELMONT AVE, CHICAGO, IL 60641-4209
(773) 725-7222
Mailing address
5236 W BELMONT AVE, CHICAGO, IL 60641-4209
(773) 725-7222
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019019497
IL
Other
Enumeration date
09/01/2009
Last updated
09/01/2009
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