| Derek L Gustafson, DDS | |
|
2467 15th St Nw, Suite A, New Brighton, MN 55112-5596 | |
| (651) 633-4883 | |
| (651) 633-4998 |
| Full Name | Derek L Gustafson |
|---|---|
| Gender | Male |
| Speciality | Dentist - General Practice |
| Location | 2467 15th St Nw, New Brighton, Minnesota |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356326029 | NPI | - | NPPES |
| DD2591 | Other | DENTAL LICENSE | |
| 12387 | Other | MN | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD2591 (New Mexico) | Secondary |
| 1223G0001X | Dentist - General Practice | 12387 (Minnesota) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Derek L Gustafson, DDS 2467 15th St Nw, Suite A, New Brighton, MN 55112-5596 Ph: (651) 633-4883 | Derek L Gustafson, DDS 2467 15th St Nw, Suite A, New Brighton, MN 55112-5596 Ph: (651) 633-4883 |
Dr. Tyler John Varhol, DDS Dentist Medicare: Medicare Enrolled Practice Location: 550 County Road D W Ste 12, New Brighton, MN 55112 Phone: 127-889-2466 | |
Dr. Grayson T West, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 2459 15th St Nw, Ste. C, New Brighton, MN 55112 Phone: 651-631-3100 Fax: 651-631-1728 | |
David A Ong, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1125 Silver Lake Road, New Brighton, MN 55112 Phone: 651-842-8426 Fax: 651-815-0379 | |
Dr. Brian Lewis Pierce, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 969 Old Highway 8 Nw, Suite 200, New Brighton, MN 55112 Phone: 651-639-8445 | |
Dr. Michael Barry Wolf, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2611 Innsbruck Dr, Suite A, New Brighton, MN 55112 Phone: 769-571-4837 Fax: 763-571-0074 | |
Abby Rachel Eisenberg, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2201 26th Ave Nw, New Brighton, MN 55112 Phone: 763-784-7993 | |
Dr. Andrew John Wahl, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 850 County Road D W, New Brighton, MN 55112 Phone: 612-788-9666 Fax: 612-788-9668 |