Provider Demographics
NPI:1427505056
Name:GOETTSCHE, ZACHARY (DDS)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:GOETTSCHE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4824 E 57TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-8614
Mailing Address - Country:US
Mailing Address - Phone:605-961-9092
Mailing Address - Fax:605-961-9093
Practice Address - Street 1:4824 E 57TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8614
Practice Address - Country:US
Practice Address - Phone:605-961-9092
Practice Address - Fax:605-961-9093
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IARES-304831223E0200X
SDD13001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics