DR. Gary Gustavson, D.D.S.

NPI #1003812579 in Skokie, Illinois

Provider Information

NPI Number: 1003812579
Entity Type: Individual
Name: DR. Gary Gustavson, D.D.S.
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Jun 21, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 64 OLD ORCHARD CTR
Address 2: STE 528
City: Skokie
State: Illinois
ZIP Code: 60077-1440
Phone: (847) 675-3311

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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