Gomola, Zachary Jacob

Gomola, Zachary Jacob is an individual health care provider with primary practice located at 3386 Niles Rd , Saint Joseph MI 49085-8800. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Gomola, Zachary Jacob can be contacted via phone (269) 281-8080.

Contact Information

Primary practice address
3386 Niles Rd Saint Joseph MI 49085-8800
Phone: (269) 281-8080
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 019.033072 Illinois
Dental Providers / General Practice 1223G0001X 2901601151 Michigan

Profile Details

NPI number 1386210730
LBN Legal business name Gomola, Zachary Jacob
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2021
Last updated Oct 5th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386210730 NPPES
Illinois Other 4438474 ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

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