Individual
DR. JACOB E GAUTHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
538 TUNICA DR W, MARKSVILLE, LA 71351-2627
(318) 253-8529
(318) 253-8595
Mailing address
538 TUNICA DR W, MARKSVILLE, LA 71351-2627
(318) 253-8529
(318) 253-8595
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5103
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851035
—
LA
Enumeration date
03/22/2007
Last updated
07/08/2007
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