DR. Eric Ross Gustavsen, DDS

NPI #1457431025 in Walla Walla, Washington

Provider Information

NPI Number: 1457431025
Entity Type: Individual
Name: DR. Eric Ross Gustavsen, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Oct 17, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1129 SOUTH 2ND AVE
Address 2: SUITE A
City: Walla Walla
State: Washington
ZIP Code: 99362
Phone: (509) 522-2522

Specialties & Taxonomy Codes

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

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