| Jack E. Goris D.d.s.,pc | |
|
1821 Chase Rd Logansport IN 46947-1200 | |
| (574) 753-4542 | |
| (574) 722-5059 |
| Full Name | Jack E. Goris D.d.s.,pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1821 Chase Rd, Logansport, Indiana |
| Authorized Official Name and Position | Jack E. Goris (PRESIDENT) |
| Authorized Official Contact | 5747534542 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack E. Goris D.d.s.,pc 1821 Chase Rd Logansport IN 46947-1200 Ph: (574) 753-4542 | Jack E. Goris D.d.s.,pc 1821 Chase Rd Logansport IN 46947-1200 Ph: (574) 753-4542 |
| NPI Number | 1588708937 |
|---|---|
| Provider Enumeration Date | 02/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588708937 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12008389 (Indiana) | Primary |
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