MELISSA MARKS GUSTAFSON DDS PA NPI 1285703876

NPI Information

MELISSA MARKS GUSTAFSON, DDS, PA is a general practice dentist in Charlotte, NC. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. MELISSA MARKS GUSTAFSON, DDS, PA NPI is 1285703876. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3010 BAUCOM RD
STE 200
CHARLOTTE, NC
ZIP 28269-983
Phone: (704) 596-0021

The provider's authorized official is Melissa Marks Gustafson .
The authorized official title is Owner and has the following contact phone number (704) 596-0021.

The enumeration date for this NPI number is 11/7/2006 and was last updated on 1/18/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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