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1346373826
TERRY L GUSTAVEL
BOISE, ID
NPI
1346373826
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: ID D-1351)
Enumeration Date
2007-03-13
Last Update Date
2007-07-08
Business Address
Dr. TERRY L GUSTAVEL D.D.S.
480 N LATAH ST
BOISE, ID 83706-2630
Phone number: 208-345-8962
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Mailing Address
Dr. TERRY L GUSTAVEL D.D.S.
480 N LATAH ST
BOISE, ID 83706-2630
Phone number: 208-345-8962
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