Gustavson, Gary
Gustavson, Gary is an individual health care provider with primary practice located at 64 Old Orchard Ctr Ste 528, Skokie IL 60077-1440. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Gustavson, Gary can be contacted via phone (847) 675-3311.Contact Information
Primary practice address
64 Old Orchard Ctr Ste 528
Skokie IL 60077-1440
Phone: (847) 675-3311
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 19-15094 | Illinois |
Profile Details
| NPI number | 1003812579 |
|---|---|
| LBN Legal business name | Gustavson, Gary |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2005 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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