Individual
DR. THOMAS G GAUTHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2530 NW MEDICAL PARK DR, ROSEBURG, OR 97471-5510
(541) 673-6511
(541) 673-6511
Mailing address
165 NW 1ST AVE, JOHN DAY, OR 97845-1101
(541) 575-0363
(541) 575-1638
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D5506
OR
Other
Enumeration date
03/05/2007
Last updated
05/01/2012
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