Derek L Gustafson is a New Brighton, Minnesota based Dentist who is specialized in Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Derek L Gustafson is 12387 for General Practice Dentistry in Minnesota. His current practice location is 2467 15th St Nw, Suite A, New Brighton. Patients can reach him at 651-633-4883.
Derek L Gustafson is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Derek L Gustafson speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Derek L Gustafson
Specialization:
Dentist
Gender:
Male
Credentials:
DDS
Accepts Medicare Assignment:
No
Practice Address:
2467 15th St Nw, Suite A, New Brighton, Minnesota, 55112-5596
Phone:
651-633-4883
Fax:
651-633-4998
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1356326029
NPI Enumeration Date:
14 Dec, 2005
NPI Last Update On:
23 Jul, 2008
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Derek L Gustafson are as mentioned below.
License Number
Specialization
State
Status
12387
General Practice Dentistry
Minnesota
Primary
DD2591
Dentistry
New Mexico
Secondary
Other Medical Identifiers:
Other legacy medical identifiers associated with Derek L Gustafson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
DD2591
Other
DENTAL LICENSE
12387
Other
Minnesota
LICENSE
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
2467 15th St Nw, Suite A New Brighton, Minnesota
Zip:
55112-5596
Phone Number:
651-633-4883
Fax Number:
651-633-4998
Patients can reach Derek L Gustafson at 2467 15th St Nw, Suite A, New Brighton, Minnesota or can call to book an appointment on 651-633-4883. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 May, 2024.