Provider Demographics
NPI:1942414263
Name:INFANTE, GUSTAVO J (DMD CAGS)
Entity Type:Individual
Prefix:DR
First Name:GUSTAVO
Middle Name:J
Last Name:INFANTE
Suffix:
Gender:M
Credentials:DMD CAGS
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Mailing Address - Street 1:29 HUDSON RD # 3220
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-1747
Mailing Address - Country:US
Mailing Address - Phone:617-645-3286
Mailing Address - Fax:978-443-4544
Practice Address - Street 1:29 HUDSON RD # 3220
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-1747
Practice Address - Country:US
Practice Address - Phone:617-645-3286
Practice Address - Fax:978-443-4544
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA211171223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics