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

DEREK L GUSTAFSON, DDS

Active Sole Proprietor

DEREK L GUSTAFSON, DDS is a General Dentistry healthcare provider located in NEW BRIGHTON, Minnesota. NPI 1356326029 is currently active in the NPPES registry. Verify at CMS.

General Dentistry · NEW BRIGHTON, MN

Registration Details

NPI Number
1356326029
Provider Type
Individual
Gender
Male
NPI Issued
Dec 14, 2005 (20.634890437507 yrs)
Last Updated
Jul 23, 2008
Licenses
DD2591 (NM)
12387 (MN)
Sole Proprietor
Yes

Practice Information

Address
2467 15TH ST NW
SUITE A
NEW BRIGHTON, MN, 551125596
Browse MN providers · Browse ZIP 55112
Phone
6516334883
Fax
6516334998
Primary Specialty
General Dentistry
1223G0001X
Additional Specialty
General Dentistry

Other General Dentistry Providers in NEW BRIGHTON, MN

Name Credential NPI
DR. JEFFREY LINN BENSON D.D.S. 1407951536
THOMAS C. HARDEL DDS 1528163854
DR. RONALD HOWARD VESCIO D.D.S. 1518043827
DR. NANCY JANE CASHMAN DDS 1679633127
DR. MARK O FINNEY DDS, PA 1376676205
DAVID A ONG DDS 1114180460
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.