Individual
DR. WILLIAM E GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
875 OLD CLEMSON HWY, SENECA, SC 29672-8060
(864) 654-5733
(864) 654-1117
Mailing address
PO BOX 349, CLEMSON, SC 29633-0349
(864) 654-5733
(864) 654-1117
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1738
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2X1738
—
SC
Enumeration date
06/21/2006
Last updated
07/08/2007
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