Individual
DR. JACK E GOTCHER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D,PH.D.
Contact information
Practice address
1928 ALCOA HWY, SUITE 305, KNOXVILLE, TN 37920-1502
(865) 305-6625
(865) 305-6628
Mailing address
PO BOX 440103, NASHVILLE, TN 37244-0103
(865) 670-6199
(865) 670-6188
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS0000003654
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3224964
—
TN
Enumeration date
10/21/2005
Last updated
11/04/2010
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