DR. Terry L Gustavel, D.D.S.

NPI #1346373826 in Boise, Idaho

Provider Information

NPI Number: 1346373826
Entity Type: Individual
Name: DR. Terry L Gustavel, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Mar 13, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 480 N LATAH ST
City: Boise
State: Idaho
ZIP Code: 83706-2630
Phone: (208) 345-8962

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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