All Medicaid billing entities listing GUSTAFSON, MARILYN (OFFICE MANAGER) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Minnesota | 1 | $2K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | LONG PRAIRIE DENTAL CLINIC LLC | LONG PRAIRIE, MN | Dentist | $2K |