Individual
DR. AIMEE JEAN GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
5 4TH AVE E, POLSON, MT 59860-2117
(406) 745-3525
Mailing address
PO BOX 880, SAINT IGNATIUS, MT 59865-0880
(406) 745-3525
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D12841
MN
122300000X
Dentist
Primary
DEN-DEN-LIC-2485
MT
1223G0001X
General Practice Dentistry
2485
MT
Other
Enumeration date
07/08/2010
Last updated
03/15/2024
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