institution
Rae A. Gauthier, Dds, Llc Dba Ponchatoula Family Dentistry
Dental Clinic/Center in Ponchatoula, Louisiana
NPI 1215446521

Rae A. Gauthier, Dds, Llc Dba Ponchatoula Family Dentistry is a Dental Clinic/Center based in Ponchatoula, LA and is specialized in Dental. Rae A. Gauthier, Dds, Llc Dba Ponchatoula Family Dentistry practices in Ponchatoula, LA. The NPI Number for Rae A. Gauthier, Dds, Llc Dba Ponchatoula Family Dentistry is 1215446521 and holds a License No. 5909 (Louisiana).

The current practice location address for Rae A. Gauthier, Dds, Llc Dba Ponchatoula Family Dentistry is 430 E Pine St, Ponchatoula, LA and can be reached out via phone at 985-687-3806 and via fax at 985-386-8467.

Location: 430 E Pine St, Ponchatoula, LA, 70454-2544
institution
Provider Profile Details
NPI Number
1215446521
Provider Name
Rae A. Gauthier, Dds, Llc Dba Ponchatoula Family Dentistry
Credential
Provider Entity Type
Organization
Address
430 E Pine St, Ponchatoula, LA, 70454-2544
Phone Number
985-687-3806
Fax Number
985-386-8467
Provider Enumeration Date
09/29/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1859095 05 LA
institution
Provider Business Practice Location Address Details
Address
430 E Pine St
City
State
Zip
70454-2544
Phone Number
985-687-3806
Fax Number
985-386-8467
person
Provider Business Mailing Address Details
Address
430 E Pine St
City
State
Zip
70454-2544
Phone Number
985-687-3806
Fax Number
985-386-8467
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
License No.
5909 (Louisiana)
Definition
Definition to come...
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