Individual
JEREMIAH GOSSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7219 N LITCHFIELD RD, LUKE AFB, AZ 85309-1529
(623) 856-2273
Mailing address
7219 N LITCHFIELD RD, LUKE AFB, AZ 85309-1529
(623) 856-2273
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DDS103017
CA
1223G0001X
General Practice Dentistry
DDS103017
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7482960
TRICARE
AK
Enumeration date
08/16/2018
Last updated
10/29/2025
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