| Melissa Marks Gustafson, Dds, Pa | |
|
3010 Baucom Rd Ste 200 Charlotte NC 28269-0983 | |
| (704) 596-0021 | |
| Not Available |
| Full Name | Melissa Marks Gustafson, Dds, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3010 Baucom Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Melissa Marks Gustafson (OWNER) |
| Authorized Official Contact | 7045960021 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Melissa Marks Gustafson, Dds, Pa 3010 Baucom Rd Ste 200 Charlotte NC 28269-0983 Ph: (704) 596-0021 | Melissa Marks Gustafson, Dds, Pa 3010 Baucom Rd Ste 200 Charlotte NC 28269-0983 Ph: (704) 596-0021 |
| NPI Number | 1285703876 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 01/18/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285703876 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7153 (North Carolina) | Primary |
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