Individual
DR. RANDY THOMAS GAUTHREAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1113 FOREMAN DR, LAFAYETTE, LA 70506-2929
(337) 988-0805
(337) 988-0811
Mailing address
1113 FOREMAN DR, LAFAYETTE, LA 70506-2929
(337) 988-0805
(337) 988-0811
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3142
LA
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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