DR. Mark Edward Gustafson, D.D.S.

NPI #1114033214 in Wooster, Ohio

Provider Information

NPI Number: 1114033214
Entity Type: Individual
Name: DR. Mark Edward Gustafson, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: D.D.S.
Enumeration Date: Aug 22, 2006
Last Updated: Sep 4, 2009

Practice Location

Address: 3431 COMMERCE PARKWAY
Address 2: SUITE A
City: Wooster
State: Ohio
ZIP Code: 44691
Phone: (330) 264-8973

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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