Organization · Type 2 NPI
Melissa Marks Gustafson, Dds, PA
Dental Clinic/Center · Charlotte, NC
NPI number
1962936104
Active
Practice location
3010 Baucom Rd Ste 200
Charlotte, NC 28269-6765
Fax (704) 599-1155
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | 7153 (NC) |
Dental Clinic/Center: Definition to come...
Another provider at this address
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About NPI 1962936104
Melissa Marks Gustafson, Dds, PA's National Provider Identifier is 1962936104, issued on Apr 14, 2017. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Charlotte, NC. The record was last updated on Apr 14, 2017.