Rae A. Gauthier, Dds, Llc Dba Ponchatoula Family Dentistry
Dental Clinic/Center in Ponchatoula, LA(View on Map)
Legal Business Name
Rae A. Gauthier, Dds, Llc Dba Ponchatoula Family Dentistry
NPI Number
1215446521
NPI Type
Organization
Enumeration Date
09/29/2017
Specialties
(Taxonomies)Licenses
State
Louisiana
License Number
5909
Contact
Information
Purpose
Mailing
Location
Address
430 E PINE ST
430 E PINE ST
City
Ponchatoula
Ponchatoula
State
LA
LA
Postal Code
70454-2544
70454-2544
Country
US
US
Telephone Number
(985) 687-3806
(985) 687-3806
Authorized Official
Name
Rae Gauthier
Title or Position
OWNER/DENTIST
Telephone Number
(985) 386-8454
Identifiers
Identifier
1859095
Identifier State
LA
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/21/2022