Provider Demographics
NPI:1639187693
Name:CAUTHEN, GERALD E (DDS)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:E
Last Name:CAUTHEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:BARNESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30204
Mailing Address - Country:US
Mailing Address - Phone:770-358-0101
Mailing Address - Fax:770-358-3089
Practice Address - Street 1:819 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30204
Practice Address - Country:US
Practice Address - Phone:770-358-0101
Practice Address - Fax:770-358-3089
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA81681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice