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Organization
MELISSA MARKS GUSTAFSON, DDS, PA
Active
Organization
MELISSA MARKS GUSTAFSON, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA MARKS GUSTAFSON DDS (OWNER)
(704) 596-0021
Entity
Organization
Contact information
Practice address
3010 BAUCOM RD, STE 200, CHARLOTTE, NC 28269-0983
(704) 596-0021
Mailing address
3010 BAUCOM RD, STE 200, CHARLOTTE, NC 28269-0983
(704) 596-0021
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7153
NC
Other
Enumeration date
11/07/2006
Last updated
01/18/2017
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