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Melissa Marks Gustafson, Dds, Pa
Dental Clinic/Center in Charlotte, North Carolina
NPI 1962936104

Melissa Marks Gustafson, Dds, Pa is a Dental Clinic/Center based in Charlotte, NC and is specialized in Dental. Melissa Marks Gustafson, Dds, Pa practices in Charlotte, NC. The NPI Number for Melissa Marks Gustafson, Dds, Pa is 1962936104 and holds a License No. 7153 (North Carolina).

The current practice location address for Melissa Marks Gustafson, Dds, Pa is 3010 Baucom Rd Ste 200, Charlotte, NC and can be reached out via phone at 704-596-0021 and via fax at 704-599-1155.

Location: 3010 Baucom Rd Ste 200, Charlotte, NC, 28269-6765
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1962936104
Provider Name
Melissa Marks Gustafson, Dds, Pa
Credential
Provider Entity Type
Organization
Address
3010 Baucom Rd Ste 200, Charlotte, NC, 28269-6765
Phone Number
704-596-0021
Fax Number
704-599-1155
Provider Enumeration Date
04/14/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3010 Baucom Rd Ste 200
City
Charlotte
State
North Carolina
Zip
28269-6765
Phone Number
704-596-0021
Fax Number
704-599-1155
person
Provider Business Mailing Address Details
Address
3010 Baucom Rd Ste 200
City
Charlotte
State
North Carolina
Zip
28269-6765
Phone Number
704-596-0021
Fax Number
704-599-1155
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
7153 (North Carolina)
Definition
Definition to come...
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