Provider Demographics
NPI:1871805515
Name:OLIVEIRA, GUSTAVO MUSSI STEFAN (DDS, MS)
Entity type:Individual
Prefix:
First Name:GUSTAVO
Middle Name:MUSSI STEFAN
Last Name:OLIVEIRA
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNC SCHOOL OF DENTISTRY
Mailing Address - Street 2:443 BRAUER HALL
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7450
Mailing Address - Country:US
Mailing Address - Phone:919-537-3242
Mailing Address - Fax:
Practice Address - Street 1:UNC SCHOOL OF DENTISTRY
Practice Address - Street 2:443 BRAUER HALL
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7450
Practice Address - Country:US
Practice Address - Phone:919-537-3242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00169122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist