| Rae A. Gauthier, Dds, Llc Dba Ponchatoula Family Dentistry | |
|
430 E Pine St Ponchatoula LA 70454-2544 | |
| (985) 687-3806 | |
| (985) 386-8467 |
| Full Name | Rae A. Gauthier, Dds, Llc Dba Ponchatoula Family Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 430 E Pine St, Ponchatoula, Louisiana |
| Authorized Official Name and Position | Rae Ann Gauthier (OWNER/DENTIST) |
| Authorized Official Contact | 9853868454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rae A. Gauthier, Dds, Llc Dba Ponchatoula Family Dentistry 430 E Pine St Ponchatoula LA 70454-2544 Ph: (985) 687-3806 | Rae A. Gauthier, Dds, Llc Dba Ponchatoula Family Dentistry 430 E Pine St Ponchatoula LA 70454-2544 Ph: (985) 687-3806 |
| NPI Number | 1215446521 |
|---|---|
| Provider Enumeration Date | 09/29/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215446521 | NPI | - | NPPES |
| 1859095 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 5909 (Louisiana) | Primary |
Douglas M George Dds Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 430 E Pine St, Ponchatoula, LA 70454 Phone: 318-348-4795 | |
Deep South Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1160 Hwy 51 North, Ponchatoula, LA 70454 Phone: 985-386-9936 | |
Northshore Dental Associates Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1160 Highway 51, Ponchatoula, LA 70454 Phone: 985-386-9936 Fax: 985-386-5712 |