Gooch, Jonathan Brent

Gooch, Jonathan Brent is an individual health care provider with primary practice located at 285 Uptown Blvd Apt 309 , Altamonte Springs FL 32701-3496. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Gooch, Jonathan Brent can be contacted via phone (904) 304-1887.

Contact Information

Primary practice address
285 Uptown Blvd Apt 309 Altamonte Springs FL 32701-3496
Phone: (904) 304-1887
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DN17917 Florida

Profile Details

NPI number 1023216363
LBN Legal business name Gooch, Jonathan Brent
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2007
Last updated Dec 22nd, 2009 - about 16 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 1023216363 NPPES
Florida MEDICAID 000956600

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