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General NPI Number Information
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NPI Number | 1912076407
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Entity Type | Individual
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Provider Name | JEFFREY E GUST D.D.S., M.S.
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1000 E 30TH AVE
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City | HUTCHINSON
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State | KS
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Zip | 67502-4227
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Country | US
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Telephone | 620-662-3255
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Fax | 620-663-1670
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Provider Business Mailing Address
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Address Line | 1000 E 30TH AVE
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City | HUTCHINSON
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State | KS
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Zip | 67502-4227
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Country | US
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Telephone | 620-662-3255
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Fax | 620-663-1670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 60374
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License Number State | KS
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