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Individual

DR. JOHN VICTOR GUSTAFSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD,MAGD,FADI

Contact information

Practice address
102 W HIGH ST, ELIZABETHTOWN, PA 17022-2019
(717) 367-1560
(717) 367-8856
Mailing address
102 W HIGH ST, ELIZABETHTOWN, PA 17022-2019
(717) 367-1560
(717) 367-8856

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS-02849-L
PA

Other

Enumeration date
09/27/2006
Last updated
07/08/2007
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