NPI 1477611432

Gary Louis Gusmerotti

Practitioner General Practice Dentistry Lac Du Flambeau, WI

Practice location

Address: 128 Old Abe Rd, Lac Du Flambeau, WI 54538-0128
Phone: (715) 588-4280
Mailing address: PO Box 128 128 Old Abe Road, Lac Du Flambeau, WI 54538-0128

Registered specialties (2)

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 5591 (WI)

Other Dentist providers in Wisconsin →

General Practice Dentistry

Dental Providers Taxonomy 1223G0001X Licence DS022509L (PA)

Registry record

NPI: 1477611432
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Dec 2006
Record last updated: 28 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.