Mark Edward Gustafson, D.D.S.

General Practice Dentistry · Wooster, OH

Individual Active NPI

NPI number 1114033214

Practice location

3431 Commerce Parkway
Suite a
Wooster, OH 44691
Phone
(330) 264-8973
Fax
(330) 262-3072

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NPI record

NPI
1114033214
Entity type
Individual (Type 1)
Enumeration date
August 22, 2006
Last updated
September 4, 2009
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 30-01-7218 OH
General Practice Dentistry 1223G0001X 30-017218 OH

About Dr. Gustafson

Mark Edward Gustafson, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 3431 Commerce Parkway, Suite a, Wooster, OH 44691. The NPI number 1114033214 was assigned on August 22, 2006 and the record was last updated on September 4, 2009.

Dr. Gustafson lists 2 licenses in the registry: #30-01-7218 (OH) for General Practice Dentistry; #30-017218 (OH) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mark Edward Gustafson, D.D.S.?

The NPI number is 1114033214.

What is the phone number of Dr. Gustafson?

The phone number listed for the practice location is (330) 264-8973.

Where is Dr. Gustafson located?

3431 Commerce Parkway, Suite a, Wooster, OH 44691.

What is the taxonomy code for Dr. Gustafson?

The primary taxonomy code is 1223G0001X – General Practice Dentistry; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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