| Kerri S. Gustafson, Dds, Pllc, Dentistry For Children | |
|
18245 E 10 Mile Rd Ste 110 Roseville MI 48066-5807 | |
| (586) 585-2402 | |
| Not Available |
| Full Name | Kerri S. Gustafson, Dds, Pllc, Dentistry For Children |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 18245 E 10 Mile Rd Ste 110, Roseville, Michigan |
| Authorized Official Name and Position | Kerri S Gustafson (DDS, OWNER) |
| Authorized Official Contact | 3039172215 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kerri S. Gustafson, Dds, Pllc, Dentistry For Children 830 Cadieux Rd Grosse Pointe MI 48230-1232 Ph: (303) 917-2215 | Kerri S. Gustafson, Dds, Pllc, Dentistry For Children 18245 E 10 Mile Rd Ste 110 Roseville MI 48066-5807 Ph: (586) 585-2402 |
| NPI Number | 1295347805 |
|---|---|
| Provider Enumeration Date | 08/17/2020 |
| Last Update Date | 08/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295347805 | NPI | - | NPPES |
| 1316910763 | Other | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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