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Individual

EDWIN FREDRICK TRAUTH IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
40470 GERMANY RD, GONZALES, LA 70737-6735
(225) 622-2022
Mailing address
122 SAM ST, BOUTTE, LA 70039-3528

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6754
LA

Other

Enumeration date
05/19/2017
Last updated
05/19/2017
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