Individual
DR. ROLAND BRANT GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6238 YELLOWSTONE RD, CHEYENNE, WY 82009-3432
(307) 635-6940
(307) 635-2839
Mailing address
6238 YELLOWSTONE RD, CHEYENNE, WY 82009-3432
(307) 635-6940
(307) 635-2839
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1054
WY
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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