Individual
JAMES WYLIE GUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 30912
(912) 604-0441
Mailing address
701 WESTMINSTER CT, AUGUSTA, GA 30909-3475
(912) 604-0441
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
DN014644
GA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/27/2013
Last updated
07/01/2020
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