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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. KERRI SUE GUSTAFSON, DDS

Active Sole Proprietor

DR. KERRI SUE GUSTAFSON, DDS is a Pediatric Dentistry healthcare provider located in ROSEVILLE, Michigan. NPI 1316910763 is currently active in the NPPES registry. Verify at CMS.

Pediatric Dentistry · ROSEVILLE, MI

Registration Details

NPI Number
1316910763
Provider Type
Individual
Gender
Female
NPI Issued
Feb 8, 2006 (20.540633423463 yrs)
Last Updated
Oct 3, 2022
Licenses
D11710 (OR)
2901018319 (MI)
Sole Proprietor
Yes

Practice Information

Address
18245 E 10 MILE RD
SUITE 110
ROSEVILLE, MI, 480665807
Browse MI providers · Browse ZIP 48066
Phone
5865852402
Fax
5864451473
Primary Specialty
Pediatric Dentistry
1223P0221X
Additional Specialty
Pediatric Dentistry
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.