Organization
KEITH R.R. GAUGHT, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH RICHARD REUBEN GAUGHT DDS (PRESIDENT)
(919) 847-6453
Entity
Organization
Contact information
Practice address
7718 SIX FORKS ROAD, SUITE 110, RALEIGH, NC 27615-5072
(919) 847-6453
Mailing address
101 HEDWIG CT, CARY, NC 27518-8693
(219) 916-6119
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
11/27/2019
Last updated
08/20/2021
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