Individual
DR. GUSTAVO MENDONCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS, PHD
Contact information
Practice address
1011 N UNIVERSITY AVE RM 3165, ANN ARBOR, MI 48109-1078
(734) 764-8597
Mailing address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2952000449
MI
1223P0700X
Prosthodontics
0108
NC
Other
Enumeration date
03/08/2011
Last updated
03/31/2022
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