Individual
CASEY GOETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
91 TROY SQ STE 201, TROY, MO 63379-3228
(636) 383-4500
(636) 383-4501
Mailing address
140 TWIN RIVERS CT, SARTELL, MN 56377-2015
(320) 257-3380
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DDS-09417
IA
390200000X
Student in an Organized Health Care Education/Training Program
09417
IA
Other
Enumeration date
04/20/2017
Last updated
11/18/2020
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