Individual
DR. MARCUS MICHAEL GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
16678 7TH ST S, LAKELAND, MN 55043-9531
(612) 867-6177
Mailing address
16678 7TH ST S, LAKELAND, MN 55043-9531
(612) 867-6177
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8384
MN
Other
Enumeration date
04/27/2006
Last updated
10/23/2015
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