Individual
GARY LOUIS GUSMEROTTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
128 OLD ABE RD, LAC DU FLAMBEAU, WI 54538-0128
(715) 588-4280
Mailing address
PO BOX 128, 128 OLD ABE ROAD, LAC DU FLAMBEAU, WI 54538-0128
(715) 588-4280
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5591
WI
1223G0001X
General Practice Dentistry
DS022509L
PA
Other
Enumeration date
12/04/2006
Last updated
01/28/2014
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