Provider Demographics
NPI:1952500365
Name:GUNSTREAM, ADRIENNE S (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:S
Last Name:GUNSTREAM
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 12TH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-1774
Mailing Address - Country:US
Mailing Address - Phone:319-351-5439
Mailing Address - Fax:319-354-0491
Practice Address - Street 1:501 12TH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-1774
Practice Address - Country:US
Practice Address - Phone:319-351-5439
Practice Address - Fax:319-354-0491
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA528611223P0300X
IA086141223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics