Individual
DR. JOSSEN P GASTELUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12090 N THORNYDALE RD STE 106, MARANA, AZ 85658-4779
(520) 616-4610
Mailing address
12090 N THORNYDALE RD STE 106, MARANA, AZ 85658-4779
(520) 616-4610
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10479
KY
1223G0001X
General Practice Dentistry
Primary
D010862
AZ
Other
Enumeration date
07/29/2020
Last updated
10/31/2020
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