OrganizationActive
Frederick Gustave, D.D.S., PC
NPI 1477720985 · Oral and Maxillofacial Surgery Clinic/Center · Carbondale, IL
Provider details
- NPI number
- 1477720985
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Frederick Gustave, Owner/Oral Surgeon
- License
- 019016600 (IL)
Practice location
1111 E Walnut St
Suite B
Carbondale, IL 62901-5000
Phone: (618) 529-2571
Fax: (618) 529-2572
Mailing address
1111 E Walnut St
Carbondale, IL 62901-5000
Registry dates
- Enumerated
- 2008-05-14
- Last updated
- 2008-05-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.