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General NPI Number Information
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NPI Number | 1023097649
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Entity Type | Individual
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Provider Name | JONAS ERWIN GAUTHIER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 5016 HIGHWAY 28 E
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City | PINEVILLE
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State | LA
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Zip | 71360-4737
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Country | US
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Telephone | 318-448-4540
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Fax | 318-484-2837
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Provider Business Mailing Address
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Address Line | 5016 HIGHWAY 28 E
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City | PINEVILLE
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State | LA
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Zip | 71360-4737
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Country | US
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Telephone | 318-448-4540
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Fax | 318-484-2837
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4961
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License Number State | LA
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