Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DS020955L | PA |
NPI | 1093795080 |
---|---|
Provider Name | Dr. James F Gustainis |
First Address | West Chester, PA 19380-4441 |
Second Address | West Chester, PA 19380-4443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 27/10/2020 |